P414 Timing of biologics discontinuation is not associated with postoperative complications (POCs), infective complications, bleeding, or intra-abdominal septic complications (IASCs) after primary ileocecal resection for Crohn’s Disease: a retrospective analysis of 237 patients in a tertiary centre Article Swipe
Giacomo Calini
,
A Canavese
,
Gerti Dajti
,
Stefano Cardelli
,
Fernando Rizzello
,
Paolo Gionchetti
,
Gilberto Poggioli
,
Matteo Rottoli
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1093/ecco-jcc/jjad212.0544
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1093/ecco-jcc/jjad212.0544
Background The role of biologics on postoperative complications in Crohn’s Disease (CD) is still debated. Recent studies showed that preoperative adalimumab, infliximab, ustekinumab, and vedolizumab were not associated with increased POCs and IASCs. While some studies defined a 12-week cut-off based on pharmacodynamics principles, the safest timing for biologics discontinuation remains unknown. We aimed to analyse different timing of biologics discontinuation and POCs, infective complications, bleeding and IASCs after primary ileocecal resection for CD. Methods This is a retrospective single-centre study including all consecutive patients undergoing primary ileocecal resection for CD between 2004-2022 and exposed preoperatively to biologics. Patients were divided into four groups according to the number of weeks between the last dose of biologics and surgery: Group 1 (≤6 weeks), Group 2 (>6 and ≤12 weeks), Group 3 (>12 and ≤30 weeks), Group 4 (>30 weeks). The primary aim was POCs. Secondary aims were postoperative Clavien-Dindo≥III complications, infective complications, bleeding and IASCs. Uni- and multivariable logistic regression analyses were performed. Results We included 237 patients who underwent primary ileocecal resection for CD with previous exposition to biologics. Group 1 (≤6w) included 42 patients, Group 2 (≤12w) 41, Group 3 (≤30w) 47, and Group 4 (>30w) 107. Patients received adalimumab (128 pts, 54%), infliximab (82 pts, 35%), ustekinumab (15 pts, 6%) or vedolizumab (11 pts, 5%). Ileocecal resection with primary anastomosis was performed in 233 patients (98%) and 31 patients (13%) had a stoma. Groups were different in age, BMI, smoking, preoperative antibiotics, Albumin, Haemoglobin, and laparoscopy with Group 1 having higher rates of major risk factors for POCs. However, POCs, postoperative Clavien-Dindo≥III complications, infective complications, bleeding and IASCs were not different among the groups. Other general characteristics and postoperative outcomes of the four groups were reported in Table 1. Logistic regression analyses comparing the study outcomes among the groups were not able to detect differences as shown in Table 2 Conclusion The present study compared outcomes of different timing of biologics discontinuation for primary ileocecal resection for CD. No difference was found in POCs, postoperative Clavien-Dindo≥III complications, infective complications, bleeding and IASCs. Considering that patients treated with biologics ≤ 6 weeks before surgery had also a higher rate of risk factors for POCs and IASCs, biologics discontinuation seems not to have any impact on them. Large prospective multicentre studies are needed to confirm the safest period of preoperatory biologics discontinuation.
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/ecco-jcc/jjad212.0544
- https://academic.oup.com/ecco-jcc/article-pdf/18/Supplement_1/i854/56348970/jjad212.0544.pdf
- OA Status
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- Cited By
- 1
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4391162136
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https://openalex.org/W4391162136Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1093/ecco-jcc/jjad212.0544Digital Object Identifier
- Title
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P414 Timing of biologics discontinuation is not associated with postoperative complications (POCs), infective complications, bleeding, or intra-abdominal septic complications (IASCs) after primary ileocecal resection for Crohn’s Disease: a retrospective analysis of 237 patients in a tertiary centreWork title
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2024Year of publication
- Publication date
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2024-01-01Full publication date if available
- Authors
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Giacomo Calini, A Canavese, Gerti Dajti, Stefano Cardelli, Fernando Rizzello, Paolo Gionchetti, Gilberto Poggioli, Matteo RottoliList of authors in order
- Landing page
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https://doi.org/10.1093/ecco-jcc/jjad212.0544Publisher landing page
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https://academic.oup.com/ecco-jcc/article-pdf/18/Supplement_1/i854/56348970/jjad212.0544.pdfDirect link to full text PDF
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YesWhether a free full text is available
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bronzeOpen access status per OpenAlex
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https://academic.oup.com/ecco-jcc/article-pdf/18/Supplement_1/i854/56348970/jjad212.0544.pdfDirect OA link when available
- Concepts
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Medicine, Discontinuation, Surgery, Retrospective cohort study, Crohn's disease, Resection, Disease, Internal medicineTop concepts (fields/topics) attached by OpenAlex
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1Total citation count in OpenAlex
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2024: 1Per-year citation counts (last 5 years)
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10Other works algorithmically related by OpenAlex
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