title: Effect of Anti-TNF Agents on Postoperative Outcomes in Inflammatory Bowel Disease Patients: a Single Institution Experience.
abstract: Anti-tumor necrosis factor (TNF) agents have been an integral part in the treatment of inflammatory bowel disease. However, a subset of inflammatory bowel disease patients ultimately requires surgery and up to 30 % of them have undergone treatment with anti-TNF agents. Studies assessing the effect of anti-TNF agents on postoperative outcomes have been inconsistent. The aim of this study is to assess postoperative morbidity in inflammatory bowel disease patients who underwent surgery with anti-TNF therapy prior to surgery.
  
  
  
  This is a retrospective review of 282 patients with inflammatory bowel disease undergoing intestinal surgery between 2013 and 2015 at the Mount Sinai Hospital. Patients were divided into two groups based on treatment with anti-TNF agents (infliximab, adalimumab, certolizumab) within 8 weeks of surgery. Thirty-day postoperative outcomes were recorded. Univariate and multivariate statistical analyses were carried out.
  
  
  
  Seventy-three patients were treated with anti-TNF therapy within 8 weeks of surgery while 209 patients did not have exposure. Thirty-day anastomotic leak, intra-abdominal abscess, wound infection, extra-abdominal infection, readmission, and mortality rates were not significantly different between the two groups.
  
  
  
  The use of anti-TNF medications in inflammatory bowel disease patients within 2 months of intestinal surgery is not associated with an increased risk of 30-day postoperative complications.
authors.affiliation: Department of Surgery, Division of General Surgery, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1041, New York, NY, 10029, USA.
authors.forename: Chaya
authors.initials: C
authors.lastname: Shwaartz
authors.affiliation: Department of Surgery, Division of General Surgery, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1041, New York, NY, 10029, USA.
authors.forename: Adam C
authors.initials: AC
authors.lastname: Fields
authors.affiliation: Department of Surgery, Division of General Surgery, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1041, New York, NY, 10029, USA.
authors.forename: Maximiliano
authors.initials: M
authors.lastname: Sobrero
authors.affiliation: Department of Surgery, Division of General Surgery, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1041, New York, NY, 10029, USA.
authors.forename: Brian D
authors.initials: BD
authors.lastname: Cohen
authors.affiliation: Department of Surgery, Division of General Surgery, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1041, New York, NY, 10029, USA. celia.divino@mountsinai.org.
authors.forename: Celia M
authors.initials: CM
authors.lastname: Divino
mesh_terms: D018784:Abdominal Abscess / Q000453:epidemiology*; D000068879:Adalimumab / Q000627:therapeutic use; D000328:Adult; D057868:Anastomotic Leak / Q000453:epidemiology*; D000068582:Certolizumab Pegol / Q000627:therapeutic use; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000601:surgery; D000069285:Infliximab / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D011184:Postoperative Period; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology*; D015996:Survival Rate; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D055815:Young Adult
chemical_list: D005765:Gastrointestinal Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068582:Certolizumab Pegol
keywords: Anti-TNF agents; Inflammatory bowel disease; Postoperative outcomes