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      Long Time from Diagnosis to Surgery May Increase Postoperative Complication Rates in Elective CD Intestinal Resections: An Observational Study

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          Abstract

          Background

          There is lack of data analyzing short-term postoperative complications and time from diagnosis to surgery in Crohn's disease (CD).

          Aim

          To compare complication rates after elective abdominal operations in CD patients with different durations of disease.

          Methods

          Retrospective observational study with CD patients who submitted to elective intestinal resections. Patients were allocated in 2 groups according to time to surgery (TS) in less or more than 5 years. Short-term postoperative complications were analyzed and compared between the 2 groups, and binary logistic regression analysis was performed to check for significant variables.

          Results

          123 patients were finally included, 77 with TS > 5 years (62.6%) and 46 with TS < 5 years (37.4%). Patients with TS > 5 years had higher rates of overall surgical complications ( p = 0.011), reoperations ( p = 0.003), surgical site infections ( p = 0.014), anastomotic dehiscence ( p = 0.021), abdominal abscesses ( p = 0.021), and overall medical complications ( p = 0.019). On logistic regression, the single significant variable was the confection of stomas (OR: 3.203; 95% CI: 1.011–10.151; p = 0.048).

          Conclusions

          Patients with longer time to surgery showed a significant increase in overall medical and surgical postoperative early complications after elective intestinal resections.

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          Most cited references12

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          Laparoscopic ileocaecal resection versus infliximab for terminal ileitis in Crohn's disease: a randomised controlled, open-label, multicentre trial

          Treatment of patients with ileocaecal Crohn's disease who have not responded to conventional therapy is commonly scaled up to biological agents, but surgery can also offer excellent short-term and long-term results. We compared laparoscopic ileocaecal resection with infliximab to assess how they affect health-related quality of life.
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            ECCO-ESCP Consensus on Surgery for Crohn’s Disease

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              • Article: not found

              Increased response and remission rates in short-duration Crohn's disease with subcutaneous certolizumab pegol: an analysis of PRECiSE 2 randomized maintenance trial data.

              We sought to analyze the efficacy (response and remission) and safety data from the PRECiSE 2 trial of certolizumab pegol according to duration of Crohn's disease since diagnosis at baseline.
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                Author and article information

                Contributors
                Journal
                Gastroenterol Res Pract
                Gastroenterol Res Pract
                GRP
                Gastroenterology Research and Practice
                Hindawi
                1687-6121
                1687-630X
                2018
                23 April 2018
                : 2018
                : 4703281
                Affiliations
                1Colorectal Surgery Unit, Cajuru University Hospital, Pontifical Catholic University of Paraná (PUCPR), Curitiba, PR, Brazil
                2Colorectal Surgery Unit, University of Campinas (UNICAMP), Campinas, SP, Brazil
                3Department of Colorectal Surgery, Humanitas Research Hospital, Rozzano, Italy
                4IBD Centre, Yokkaichi Hazu Medical Centre, Yokkaichi, Japan
                5Department of Colorectal Surgery, St. Mark's Hospital, Harrow, UK
                Author notes

                Academic Editor: Amosy M'Koma

                Author information
                http://orcid.org/0000-0002-9632-6691
                http://orcid.org/0000-0002-8180-6254
                http://orcid.org/0000-0001-8088-427X
                Article
                10.1155/2018/4703281
                5937388
                29849589
                01ededa1-824f-4432-aba6-36c6a1b7721c
                Copyright © 2018 Paulo Gustavo Kotze et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 13 December 2017
                : 24 February 2018
                : 27 March 2018
                Categories
                Research Article

                Gastroenterology & Hepatology
                Gastroenterology & Hepatology

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