Effect of immunosuppressive medication on postoperative complications following abdominal surgery in Crohn’s disease patients

• Published in: International journal of colorectal disease Vol. 37; no. 12; pp. 2535 - 2542
• Main Authors: Lahes, Saleh, Fischer, Celine, Spiliotis, Antonios E., Schulz, Antje, Gäbelein, Gereon, Igna, Dorian, Glanemann, Matthias
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2022; Springer; Springer Nature B.V
• Subjects: Abdominal surgery; Analysis; Anastomosis; Anastomosis, Surgical - adverse effects; Complications; Complications and side effects; Crohn Disease - complications; Crohn Disease - drug therapy; Crohn Disease - surgery; Crohn's disease; Digestive System Surgical Procedures - adverse effects; Drug therapy; Drugs; Gastroenterology; Hepatology; Humans; Immunosuppressive agents; Immunosuppressive Agents - adverse effects; Immunotherapy; Internal Medicine; Intestine; Medicine; Medicine & Public Health; Multivariate analysis; Patients; Postoperative; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Proctology; Remission; Retrospective Studies; Risk factors; Statistical analysis; Study Protocol; Surgery; Surgical outcomes; Colorectal surgery; Immunosuppressive agents; Postoperative complications; Crohn’s disease
• ISSN: 1432-1262; 0179-1958; 1432-1262
• DOI: 10.1007/s00384-022-04287-4

Background Immunosuppressants represent an effective pharmacological treatment for the remission and management of Crohn’s disease (CD); however, it has not been well-defined if these medications are associated with an increased incidence of postoperative complications after intestinal surgery. This retrospective study evaluated the association between immunosuppressive treatment and complications following bowel resection in patients with CD. Methods A total of 426 patients with CD who underwent abdominal surgery between 2001 and 2018 were included in the study. The participants were divided into two groups. In the first group, patients were under immunosuppressive treatment at the time of surgical resection, while in the second group, patients had never received pharmacological therapy for CD before surgery. Results No statistically significant difference was found in the incidence of postoperative complications between the two groups. Double or triple immunosuppressive therapy was not associated with increased complications compared to monotherapy or no pharmacological treatment. Preoperative risk factors such as hypoalbuminemia, abscess, fistula, intestinal perforation, long duration of symptoms, and the intraoperative performance of more than one anastomosis were related to increased rates of postoperative complications. Factors affecting the occurrence of postoperative complications in the univariate analysis were included in the multivariate analysis using a stepwise logistic regression model, and these factors were also related to increased rates of postoperative surgical complications. Conclusion Immunosuppressive therapy was not associated with increased rates of postoperative complications following bowel resection in patients with CD.