The impact of preoperative use of infliximab on postoperative complications in patients with Crohn's disease

摘要

Postoperative complications may develop more frequently in Crohn's disease (CD) than in other digestive diseases, because CD is frequently associated with possible risk factors for postoperative complications: impaired nutritional status, chronic corticosteroid and immunosuppressive medications, and preexisting sepsis such as enteric fistula and intra-abdominal abscess. Before the era of biologies, Yamamoto et al.1 found that septic complications such as anastomotic leak, intra-abdominal abscess, and enteric fistula were significantly associated with preoperative low albumin level, preoperative steroids use, abscess at the time of laparotomy, and fistula at the time of laparotomy. The intra-abdominal septic complication rate was 50% in patients with all of these four risk factors, 29% in patients with three risk factors, 14% in patients with two risk factors, 16% in patients with one risk factor, and 5% in patients with none of these risk factors.