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Anti-TNF Therapy Is Associated With an Increased Risk of Postoperative Morbidity After Surgery for Ileocolonic Crohn Disease

hal.structure.identifierService de Chirurgie générale et digestive [CHU Le Kremlin-Bicêtre]
dc.contributor.authorBROUQUET, Antoine
hal.structure.identifierService de Gastroentérologie [Hôpital Beaujon]
dc.contributor.authorMAGGIORI, Léon
hal.structure.identifierService de Chirurgie Générale et Digestive[Lille]
dc.contributor.authorZERBIB, Philippe
hal.structure.identifierCentre de Recherche Saint-Antoine [UMRS893]
dc.contributor.authorLEFÈVRE, Jérémie
hal.structure.identifierBioingénierie tissulaire [BIOTIS]
hal.structure.identifierService de Chirurgie digestive [Bordeaux]
dc.contributor.authorDENOST, Quentin
hal.structure.identifierService de Chirurgie Digestive Hépatobiliaire et Endocrine [CHRU Nancy]
dc.contributor.authorGERMAIN, Adeline
hal.structure.identifierCentre Hospitalier Lyon Sud, Service de Chirurgie Digestive
dc.contributor.authorCOTTE, Eddy
hal.structure.identifierLaboratoire de Biomécanique Appliquée [LBA UMR T24]
dc.contributor.authorBEYER-BERJOT, Laura
hal.structure.identifierDepartment of Gastroenterological Surgery
dc.contributor.authorMUNOZ-BONGRAND, Nicolas
hal.structure.identifierCentre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
dc.contributor.authorDESFOURNEAUX, Véronique
hal.structure.identifierCentre Hospitalier Universitaire de Nice [CHU Nice]
dc.contributor.authorRAHILI, Amine
hal.structure.identifierChirurgie Générale et Digestive [Rangueil]
dc.contributor.authorDUFFAS, Jean-Pierre
hal.structure.identifierDepartment of Gastroenterological Surgery
dc.contributor.authorPAUTRAT, Karine
hal.structure.identifierHôpital Lariboisière
dc.contributor.authorDENET, Christine
hal.structure.identifierService de Chirurgie Digestive [CHU Rouen]
hal.structure.identifierNutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau [ADEN]
hal.structure.identifierInstitute for Research and Innovation in Biomedicine [IRIB]
hal.structure.identifierUNIROUEN - UFR Santé [UNIROUEN UFR Santé]
dc.contributor.authorBRIDOUX, Valérie
hal.structure.identifierCentre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
dc.contributor.authorMEURETTE, Guillaume
hal.structure.identifierUnité de Chirurgie Colorectale
dc.contributor.authorFAUCHERON, Jean-Luc
hal.structure.identifierGroupe Hospitalier Paris Saint-Joseph [hpsj]
dc.contributor.authorLORIAU, Jérôme
hal.structure.identifierHépato-gastro-entérologie
dc.contributor.authorGUILLON, Françoise
hal.structure.identifierGroupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris]
dc.contributor.authorVICAUT, Eric
hal.structure.identifierService de Chirurgie générale et digestive [CHU Le Kremlin-Bicêtre]
dc.contributor.authorBENOIST, Stéphane
hal.structure.identifierHôpital Beaujon
dc.contributor.authorPANIS, Yves
dc.date.accessioned2021-06-10T07:05:10Z
dc.date.available2021-06-10T07:05:10Z
dc.date.issued2018
dc.identifier.issn0003-4932
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/79008
dc.description.abstractEnObjective: To determine the risk factors of morbidity after surgery for ileocolonic Crohn disease (CD).<br>Summary Background Data: The risk factors of morbidity after surgery for CD, particularly the role of anti-TNF therapy, remain controversial and have not been evaluated in a large prospective cohort study. <br>Methods: From 2013 to 2015, data on 592 consecutive patients who underwent surgery for CD in 19 French specialty centers were collected prospectively. Possible relationships between anti-TNF and postoperative overall morbidity were tested by univariate and multivariate analyses. Because treatment by anti-TNF is possibly dependent on the characteristics of the patients and disease, a propensity score was calculated and introduced in the analyses using adjustment of the inverse probability of treatment-weighted method.<br>Results: Postoperative mortality, overall and intra-abdominal septic morbidity rates in the entire cohort were 0%, 29.7%, and 8.4%, respectively; 143 (24.1%) patients had received anti-TNF <3 months prior to surgery. In the multivariate analysis, anti-TNF <3 months prior to surgery was identified as an independent risk factor of the overall postoperative morbidity (odds-ratio [OR] =1.99; confidence interval [CI] 95% = 1.17–3.39, P = 0.011), with preoperative hemoglobin <10 g/dL (OR = 4.77; CI 95% = 1.32–17.35, P = 0.017), operative time >180 min (OR = 2.71; CI 95% = 1.54–4.78, P < 0.001) and recurrent CD (OR = 1.99; CI 95% = 1.13–3.36, P = 0.017). After calculating the propensity score and adjustment according to the inverse probability of treatment-weighted method, anti-TNF <3 months prior to surgery remained associated with a higher risk of overall (OR = 2.98; CI 95% = 2.04–4.35, P <0.0001) and intra-abdominal septic postoperative morbidities (OR = 2.22; CI 95% = 1.22–4.04, P = 0.009).<br>Conclusions: Preoperative anti-TNF therapy is associated with a higher risk of morbidity after surgery for ileocolonic CD. This information should be considered in the surgical management of these patients, particularly with regard to the preoperative preparation and indication of temporary defunctioning stoma.
dc.language.isoen
dc.publisherLippincott, Williams & Wilkins
dc.title.enAnti-TNF Therapy Is Associated With an Increased Risk of Postoperative Morbidity After Surgery for Ileocolonic Crohn Disease
dc.typeArticle de revue
dc.identifier.doi10.1097/SLA.0000000000002017
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologie/Hépatologie et Gastroentérologie
bordeaux.journalAnnals of Surgery
bordeaux.page221-228
bordeaux.volume267
bordeaux.hal.laboratoriesBioingénierie Tissulaire (BioTis) - U1026*
bordeaux.issue2
bordeaux.institutionCNRS
bordeaux.institutionINSERM
bordeaux.institutionCHU de Bordeaux
bordeaux.institutionInstitut Bergonié
bordeaux.peerReviewedoui
hal.identifierhal-02315501
hal.version1
hal.origin.linkhttps://hal.archives-ouvertes.fr//hal-02315501v1
bordeaux.COinSctx_ver=Z39.88-2004&amp;rft_val_fmt=info:ofi/fmt:kev:mtx:journal&amp;rft.jtitle=Annals%20of%20Surgery&amp;rft.date=2018&amp;rft.volume=267&amp;rft.issue=2&amp;rft.spage=221-228&amp;rft.epage=221-228&amp;rft.eissn=0003-4932&amp;rft.issn=0003-4932&amp;rft.au=BROUQUET,%20Antoine&amp;MAGGIORI,%20L%C3%A9on&amp;ZERBIB,%20Philippe&amp;LEF%C3%88VRE,%20J%C3%A9r%C3%A9mie&amp;DENOST,%20Quentin&amp;rft.genre=article


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