Abstract
Despite the widespread use of medical therapy in the management of inflammatory bowel disease (IBD), up to 30 % of patients with ulcerative colitis (UC) and 70 % of patients with Crohn’s disease (CD) will require intra-abdominal surgery. Patients with IBD are at risk for postoperative complications including surgical site infection, intra-abdominal abscess, bacteremia, strictures and fistulae, small bowel obstruction, portal vein thrombosis, and poor wound healing including anastomotic leak and wound dehiscence.
This chapter focuses on evidence for IBD patients undergoing intra-abdominal surgery; however, the medication recommendations are applicable for IBD patients undergoing other types of surgery.
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References
Narula N, Charleton D, Marshall JK. Meta-analysis: peri-operative anti-TNFα treatment and post-operative complications in patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2013;37(11):1057–64. doi:10.1111/apt.12313.
Nasir BS, Dozois EJ, Cima RR, et al. Perioperative anti-tumor necrosis factor therapy does not increase the rate of early postoperative complications in Crohn’s disease. J Gastrointest Surg. 2010;14(12):1859–66. doi:10.1007/s11605-010-1341-5.
Appau KA, Fazio VW, Shen B, et al. Use of infliximab within 3 months of ileocolonic resection is associated with adverse postoperative outcomes in Crohn’s patients. J Gastrointest Surg. 2008;12(10):1738–44. doi:10.1007/s11605-008-0646-0.
Bafford AC, Powers S, Ha C, et al. Immunosuppressive therapy does not increase operative morbidity in patients with Crohn's disease. J Clin Gastroenterol. 2013;47(6):491–5. doi:10.1097/MCG.0b013e3182677003.
Beddy D, Dozois EJ, Pemberton JH. Perioperative complications in inflammatory bowel disease. Inflamm Bowel Dis. 2011;17(7):1610–9. doi:10.1002/ibd.21504.
Kunitake H, Hodin R, Shellito PC, Sands BE, Korzenik J, Bordeianou L. Perioperative treatment with infliximab in patients with Crohn’s disease and ulcerative colitis is not associated with an increased rate of postoperative complications. J Gastrointest Surg. 2008;12(10):1730–7. doi:10.1007/s11605-008-0630-8.
Lichtenstein GR, Feagan BG, Cohen RD, et al. Serious infection and mortality in patients with Crohn’s disease: more than 5 years of follow-up in the TREAT™ registry. Am J Gastroenterol. 2012;107(9):1409–22. doi:10.1038/ajg.2012.218.
Kumar A, Auron M, Aneja A, Mohr F, Jain A, Shen B. Inflammatory bowel disease: perioperative pharmacological considerations. Mayo Clin Proc. 2011;86(8):748–57. doi:10.4065/mcp.2011.0074.
Sewell JL, Mahadevan U. Infliximab and surgical complications: truth or perception? Gastroenterology. 2009;136(1):354–5. doi:10.1053/j.gastro.2008.11.057.
Ali T. Risk of post-operative complications associated with anti-TNF therapy in inflammatory bowel disease. WJG. 2012;18(3):197. doi:10.3748/wjg.v18.i3.197.
Nørgård BM, Nielsen J, Qvist N, Gradel KO, de Muckadell OBS, Kjeldsen J. Pre-operative use of anti-TNF-α agents and the risk of post-operative complications in patients with Crohn's disease – a nationwide cohort study. Aliment Pharmacol Ther. 2012;37(2):214–24. doi:10.1111/apt.12159.
Nørgård BM, Nielsen J, Qvist N, Gradel KO, Muckadell OBS, Kjeldsen J. Pre-operative use of anti-TNF-α agents and the risk of post-operative complications in patients with ulcerative colitis – a nationwide cohort study. Aliment Pharmacol Ther. 2012;35(11):1301–9. doi:10.1111/j.1365-2036.2012.05099.x.
Singh S, Graff LA, Bernstein CN. Do NSAIDs, antibiotics, infections, or stress trigger flares in IBD? Am J Gastroenterol. 2009;104(5):1298–314. doi:10.1038/ajg.2009.15.
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Berger, G. (2015). Inflammatory Bowel Disease. In: Jackson, M.B., Mookherjee, S., Hamlin, N.P. (eds) The Perioperative Medicine Consult Handbook. Springer, Cham. https://doi.org/10.1007/978-3-319-09366-6_17
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DOI: https://doi.org/10.1007/978-3-319-09366-6_17
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