Authors: Kopylov Uri BenHorin Shomron Zmora Oded Eliakim Rami Katz Lior H
Publish Date: 2012/12/01
Volume: 18, Issue: 12, Pages: 2404-2413
Abstract
Uri Kopylov Shomron BenHorin Oded Zmora Rami Eliakim Lior H Katz Antitumor Necrosis Factor and Postoperative Complications in Crohns Disease Systematic Review and Metaanalysis Inflammatory Bowel Diseases Volume 18 Issue 12 1 December 2012 Pages 2404–2413 https//doiorg/101002/ibd22954Antitumor necrosis factor TNF antibodies are efficacious in patients with Crohns disease CD but the influence of these medications on surgical outcomes in CD patients has been frequently debated The aim was to evaluate the impact of preoperative treatment with antiTNF antibodies on postoperative complications in CD patients undergoing abdominal surgeryA systematic review and metaanalysis of comparative cohort studies was performed assessing postoperative complication rates in CD patients who were treated with antiTNF antibodies within 3 months before surgery versus patients who were not The primary outcome was overall complication rate within 1 month of surgery Secondary outcomes included the rate of infectious and noninfectious complications The quality of studies was assessed based on selection of patients and controls comparability of the study groups and assessment of outcomes Odds ratios OR with 95 confidence intervals CIs were computedA total of eight studies including 1641 patients were included in our metaanalysis Preoperative infliximab therapy in CD patients undergoing abdominal surgery was associated with a trend toward an increased rate of total complications OR 172 95 CI 093–319 AntiTNF treatments were associated with a modestly increased risk of infectious complications OR 150 95 CI 108–208 mostly remote from the surgical site OR 207 95 CI 130–330 and with a trend toward a higher rate of noninfectious complications OR 200 95 CI 089–446
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