title: Infliximab does not affect postoperative complication rates in Crohn's patients undergoing abdominal surgery.
abstract: BACKGROUND
  In patients with Crohn's disease (CD), the effect of anti-tumor necrosis factor alpha (TNF-α) antibody therapy on postoperative complications remains unclear. We aimed to determine the effects of infliximab on postoperative complication rates in patients undergoing abdominal surgery for CD.
  
  
  METHODS
  Infliximab-treated CD patients undergoing abdominal surgery were identified in a prospective database. Gender- and age-matched CD patients without infliximab treatment served as controls. General and complication-related information was retrieved from patient records.
  
  
  RESULTS
  Forty-eight patients underwent abdominal surgery within 3 months (median 60 days, range 1-90 days) after infliximab administration (56% female, median age 35 years, range 17-66 years). Forty-eight patients without infliximab served as controls (50% female, 39 [17-68] years). Patient characteristics and number of minor complications were comparable between groups: wound infection (infliximab: 19% vs. controls: 15%), prolonged postoperative ileus (15% vs. 4%), and urinary tract infection (2% vs. 0%; all P > 0.05). No differences were found in major complications: anastomotic leakage (infliximab: 4% vs. controls: 13%), abscess formation (6% vs. 10%), bowel perforation (2% vs. 4%), stoma complication (6% vs. 2%), postoperative hemorrhage (8% vs. 2%), and enterocutaneous fistula (4% vs. 0%; all P > 0.05). One malnourished infliximab-treated patient with a complicated course of disease died postoperatively after anastomotic leakage, sepsis, and cardiac arrhythmia. Eleven infliximab and 10 control patients required reoperation (P > 0.05). Hospital stay was comparable between groups (infliximab: 13 [5-41] vs. controls: 12 [5-54] days; P > 0.05).
  
  
  CONCLUSIONS
  Infliximab does not affect postoperative complication rates, suggesting no need to alter surgical management in these patients.
authors.affiliation: Department of Surgery, Grosshadern, Ludwig-Maximilians-University Munich, Munich, Germany.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Kasparek
authors.forename: Andreas
authors.initials: A
authors.lastname: Bruckmeier
authors.forename: Florian
authors.initials: F
authors.lastname: Beigel
authors.forename: Mario H
authors.initials: MH
authors.lastname: Müller
authors.forename: Stephan
authors.initials: S
authors.lastname: Brand
authors.forename: Ulrich
authors.initials: U
authors.lastname: Mansmann
authors.forename: Karl-Walter
authors.initials: KW
authors.lastname: Jauch
authors.forename: Thomas
authors.initials: T
authors.lastname: Ochsenkühn
authors.forename: Martin E
authors.initials: ME
authors.lastname: Kreis
mesh_terms: D000068879:Adalimumab; D000293:Adolescent; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D003424:Crohn Disease / Q000188:drug therapy* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab