Preoperative infliximab treatment and postoperative complications after laparoscopic restorative proctocolectomy with ileal pouch-anal anastomosis: a case-matched study.
BACKGROUND
Infliximab offers promising new therapeutic options for treatment of moderate to severe ulcerative colitis. However, several studies suggest that it increases postoperative complication rates for patients who later require a restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA). This study aimed to assess the postoperative course of patients after laparoscopic IPAA, comparing those who had and those who had not received infliximab before surgery.


METHODS
The authors identified patients from their institution's IPAA database, finding 13 patients who had received preoperative infliximab treatment. Using age, gender, and type of procedure (2 or 3 stages) as criteria, they matched these cases with infliximab-naive patients drawn from the same database. The differences in perioperative data between the two groups were analyzed. Complications and their severity were assessed using the Strasberg classification.


RESULTS
No significant difference was found between patients treated with and those treated without infliximab for each variable studied, namely, mean operative time (353 vs. 355 min), complication rate (23 vs. 38%), and mean hospital stay (22 vs. 25 days).


CONCLUSIONS
The study findings showed no adverse impact from previous infliximab therapy on the laparoscopic IPAA postoperative course.
Coquet-Reinier
Benjamin
B
Department of Digestive Diseases Surgery, Hôpital Nord, Chemin des Bourrellys, 13915 Marseille Cedex 20, France.
Berdah
Stéphane V
SV
Grimaud
Jean-Charles
JC
Birnbaum
David
D
Cougard
Pierre-Alain
PA
Barthet
Marc
M
Desjeux
Ariadne
A
Moutardier
Vincent
V
Brunet
Christian
C
D000328:Adult; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D039021:Colonic Pouches; D005260:Female; D006801:Humans; D000069285:Infliximab; D010535:Laparoscopy; D008297:Male; D011183:Postoperative Complications / Q000139:chemically induced* / Q000453:epidemiology; D011300:Preoperative Care; D016737:Proctocolectomy, Restorative / Q000379:methods*
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D000069285:Infliximab