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Multicenter Study
. 2021 Jun;406(4):1165-1172.
doi: 10.1007/s00423-020-02038-z. Epub 2020 Dec 2.

Surgical treatment of colonic Crohn's disease: a national snapshot study

SICCR Current status of Crohn’s disease surgery collaborative
Collaborators
Multicenter Study

Surgical treatment of colonic Crohn's disease: a national snapshot study

SICCR Current status of Crohn’s disease surgery collaborative. Langenbecks Arch Surg. 2021 Jun.

Erratum in

  • Correction to: Surgical treatment of colonic Crohn's disease: a national snapshot study.
    SICCR current status of Crohn’s disease surgery collaborative; Celentano V, Pellino G, Rottoli M, Poggioli G, Sica G, Giglio MC, Campanelli M, Coco C, Rizzo G, Sionne F, Colombo F, Sampietro G, Lamperti G, Foschi D, Ficari F, Vacca L, Cricchio M, Giudici F, Selvaggi L, Sciaudone G, Peltrini R, Manfreda A, Bucci L, Galleano R, Ghazouani O, Zorcolo L, Deidda S, Restivo A, Braini A, Di Candido F, Sacchi M, Carvello M, Martorana S, Bordignon G, Angriman I, Variola A, Barugola G, Di Ruscio M, Tanzanu M, Geccherle A, Tropeano FP, Luglio G, Sasia D, Migliore M, Giuffrida MC, Marrano E, Moretto G, Impellizzeri H, Gallo G, Vescio G, Sammarco G, Terrosu G, Calini G, Bondurri A, Maffioli A, Zaffaroni G, Resegotti A, Mistrangelo M, Allaix ME, Botti F, Prati M, Boni L, Perotti S, Mineccia M, Giuliani A, Romano L, Graziano GMP, Pugliese L, Pietrabissa A, Delaini G, Spinelli A, Selvaggi F. SICCR current status of Crohn’s disease surgery collaborative, et al. Langenbecks Arch Surg. 2022 Dec;407(8):3921-3924. doi: 10.1007/s00423-021-02119-7. Langenbecks Arch Surg. 2022. PMID: 33651161 Free PMC article. No abstract available.

Abstract

Aim: The different surgical options for patients with colonic Crohn's disease (CD) include segmental colectomy, subtotal colectomy or proctocolectomy with end ileostomy. We present a national, multicentre study, promoted by the Italian Society of Colorectal Surgery with the aim to collect benchmark data and national variations on multidisciplinary management and postoperative outcomes of patients undergoing surgery for colonic CD.

Methods: All adult patients having elective surgery for colonic CD from June 2018 to May 2019 were eligible for participation in this retrospective study. The primary outcome measure was postoperative morbidity within 30 days of surgery.

Results: One hundred twenty-two patients were included: 55 subtotal colectomy, 30 segmental colectomy, 25 proctectomy and 12 proctocolectomy. Eighty-six patients (70.4%) were discussed at the inflammatory bowel disease (IBD) multidisciplinary team meeting (MDT) prior to surgery. This ranged from 76.6% for segmental colectomy to 60% for subtotal colectomy, 66.6% for proctocolectomy and 48% for proctectomy. The proportion of patients counselled by a stoma nurse preoperatively was 50%. Laparoscopy was associated with reduced postoperative morbidity (p = 0.017) and shorter length of hospital stay (p < 0.001), whilst pre-operative anti-TNF was associated with Dindo-Clavien ≥ 3 complications (p = 0.023) and longer in-hospital stay (p = 0.007). The main procedure performed (segmental colectomy, subtotal colectomy, proctocolectomy or proctectomy) was not associated with postoperative morbidity (p = 0.626).

Conclusions: Surgery for colonic CD has a high rate of postoperative complications. Almost a third of the patients were not preoperatively discussed at the IBD MDT, whilst the use of minimally invasive surgery for surgical treatment of colonic CD ranges from 40 to 66%.

Keywords: Crohn’s colitis; Crohn’s disease; Inflammatory bowel disease; National audit; Proctocolectomy; Segmental colectomy.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Number of surgical resections performed for colonic Crohn’s disease in the 20 participating hospitals
See this image and copyright information in PMC

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