Effect of infliximab on short-term complications in patients undergoing operation for chronic ulcerative colitis.

Effect of infliximab on short-term complications in patients undergoing operation for chronic ulcerative colitis. Research Abstract Details 

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Effect of infliximab on short-term complications in patients undergoing operation for chronic ulcerative colitis. Abstract Text:

Giovanni C Actis,Rinaldo Pellicano,Marco Pinna-Pintor,Mario Rizzetto,

BACKGROUND: Total proctocolectomy and ileal pouch anal anastomosis (IPAA) is the preferred operation for patients with chronic ulcerative colitis (CUC) refractory to medical therapy. Infliximab (IFX), an antitumor necrosis factor-alpha antibody, has demonstrated efficacy in medical management of CUC. The aim of this study is to determine if IFX before IPAA impacts short-term outcomes. STUDY DESIGN: A prospective institutional database was retrospectively reviewed for short-term complications after IPAA for CUC. Postoperative outcomes were compared between patients who received pre-IPAA IFX and those who did not. RESULTS: Between 2002 and 2005, 47 patients received IFX before IPAA, and 254 patients received none. There were no gender (p = 0.16) or body mass index (p = 0.07) differences between groups. IFX patients were younger than non-IFX patients (mean age 28.1 to 39.3 years) (p < 0.001). In IFX patients, 70% were receiving preoperative IFX, azathioprine, and corticosteroids. Mortality was nil. Overall surgical morbidity was similar: 61.7% and 48.8%, IFX and non-IFX, respectively (p = 0.10). Anastomotic leaks (p = 0.02), pouch-specific (p = 0.01) and infectious (p < 0.01) complications were more common in IFX patients. Multivariable analysis revealed IFX as the only factor independently associated with infectious complications (odds ratio [OR] = 3.5; CI, 1.6-7.5). In a separate analysis, incorporating age, high-dose corticosteroids, azathioprine, and severity of colitis, IFX remained significantly associated with infectious complications (OR = 2.7; CI, 1.1-6.7). CONCLUSIONS: CUC patients treated with IFX before IPAA have substantially increased the odds of postoperative pouch-related and infectious complications. Additional prospective studies are required to determine if IFX alone or other factors contribute to the observed increases in infectious complications.

Effect of infliximab on short-term complications in patients undergoing operation for chronic ulcerative colitis. Publishing Authors By Initials

GC Actis,R Pellicano,M Pinna-Pintor,M Rizzetto,

For similar diagnosis: prognosis: treatment outcome research abstracts see: diagnosis: prognosis: treatment outcome research

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Effect of infliximab on short-term complications in patients undergoing operation for chronic ulcerative colitis. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Journal of the American College of Surgeons

VOLUME: 204

Page Numbers: 956-62; discussion 962-3

Journal Abbreviation:

ISSN: 1072-7515

DAY: 26

MONTH: May

YEAR: 2007

Effect of infliximab on short-term complications in patients undergoing operation for chronic ulcerative colitis. Information

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LANGUAGE: eng

NlmUniqueID: 9431305

Effect of infliximab on short-term complications in patients undergoing operation for chronic ulcerative colitis. Keywords Mesh Terms:

KEYWORDS: Treatment Outcome

MESH TERMS: drug therapy

Chemical & Substance for Abstract: Effect of infliximab on short-term complications in patients undergoing operation for chronic ulcerative colitis. Information

Substance Name: infliximab

Registry Number: 0

Grant and Affiliation Information for Effect of infliximab on short-term complications in patients undergoing operation for chronic ulcerative colitis.

AFFILIATION: Division of Colon and Rectal Surgery, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.

Country: United States

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MEDLINETA: J Am Coll Surg

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