The effect of immune therapy on surgical site infection following Crohn's Disease resection.
Fiche publication
Date publication
juillet 2013
Auteurs
Membres identifiés du Cancéropôle Est :
Pr ROHR Serge, Dr ROMAIN Benoit, Pr PEYRIN-BIROULET Laurent, Pr GERMAIN Adeline
Tous les auteurs :
Serradori T, Germain A, Scherrer ML, Ayav C, Perez M, Romain B, Palot JP, Rohr S, Peyrin-Biroulet L, Bresler L
Lien Pubmed
Résumé
BACKGROUND: Patients with Crohn's disease are increasingly receiving antitumour necrosis factor alpha (anti-TNF-alpha) therapy. Whether anti-TNF-alpha therapy increases the risk of postoperative infectious complications in Crohn's disease is a matter of debate. METHODS: This was a retrospective study of three referral centres. The charts of patients who underwent ileocaecal or ileocolonic resection for Crohn's disease between 2000 and 2011 were reviewed. The impact of baseline characteristics and Crohn's disease-related medications on the risk of postoperative intra-abdominal infectious complications was investigated by univariable and multivariable analysis. RESULTS: A total of 217 patients were included in the study. Median age at the time of surgery was 36.8 (range 15-78) years. A postoperative intra-abdominal infection occurred in 24 (11.1 per cent) of 217 patients. No deaths were reported. On univariable analysis, age less than 25 years (P = 0.023), steroid use (P = 0.017), anti-TNF-alpha therapy (P = 0.043) and anti-TNF-alpha treatment in combination with steroids (P = 0.004) were associated with an increased risk of postoperative intra-abdominal infectious complications. On multivariable analysis, only anti-TNF-alpha therapy in combination with steroids significantly increased this risk (odds ratio 8.03, 95 per cent confidence interval 1.93 to 33.43; P = 0.035). CONCLUSION: Combined use of steroids and anti-TNF-alpha therapy was associated with an increased risk of postoperative intra-abdominal infectious complications.
Référence
Br J Surg. 2013 Jul;100(8):1089-93