Safety of perioperative treatment with biologics in patients with inflammatory bowel disease undergoing bowel surgery: Experience from a large urban center.
<h4>Background and aims</h4>Risks of peri- and postoperative complications after bowel surgery in patients with inflammatory bowel disease (IBD) receiving biologics are still discussed controversially. We therefore addressed the safety of different biologics that were applied in our IBD...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2024-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0290887&type=printable |
| _version_ | 1797349344971587584 |
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| author | Fabian Schnitzler Cornelia Tillack-Schreiber Daniel Szokodi Isabel Braun June Tomelden Maximilian Sohn Franz Bader Constanze Waggershauser Thomas Ochsenkühn |
| author_facet | Fabian Schnitzler Cornelia Tillack-Schreiber Daniel Szokodi Isabel Braun June Tomelden Maximilian Sohn Franz Bader Constanze Waggershauser Thomas Ochsenkühn |
| author_sort | Fabian Schnitzler |
| collection | DOAJ |
| description | <h4>Background and aims</h4>Risks of peri- and postoperative complications after bowel surgery in patients with inflammatory bowel disease (IBD) receiving biologics are still discussed controversially. We therefore addressed the safety of different biologics that were applied in our IBD center before surgery.<h4>Methods</h4>Data of IBD patients who underwent bowel resections between 2012 and 2022 at our hospital were analyzed retrospectively. Exposure to biologics was defined by receiving biologics within 12 weeks before resective abdominal surgery. Safety considerations included minor complications, such as infections and wound healing disorders and major complications, e.g., anastomotic insufficiency or abscess formation.<h4>Results</h4>A total of 447 IBD patients (334 with Crohn's disease, 113 with ulcerative colitis), 51.9% female, were included and followed for a median follow-up of 45 months [range 0-113]. A total of 73.9% (326/447) were undergoing medical treatment at date of surgery, 61.5% (275/447) were treated with biologics within 3 months and 42.3% (189/447) within 4 weeks before surgery. Most surgeries (97.1%) were planned electively and 67.8% were performed laparoscopically. Major and minor complications occurred in 20.8% (93/447) of patients. Serious complications were rare: Six patients had acute postoperative bleeding, one CD patient developed peritonitis and two CD patients died postoperatively. After adjusting for age, disease duration, disease activity, Montreal classification, and medical treatment at date of surgery, no significant differences were observed regarding complications and exposure to biologics.<h4>Conclusions</h4>This retrospective single center study of 447 IBD patients goes to demonstrate that perioperative use of biologics is not associated with a higher risk of complications. |
| first_indexed | 2024-03-08T12:28:59Z |
| format | Article |
| id | doaj.art-1bd19f63ba014adc8e8de912ab2c0174 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-03-08T12:28:59Z |
| publishDate | 2024-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-1bd19f63ba014adc8e8de912ab2c01742024-01-22T05:31:28ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-01191e029088710.1371/journal.pone.0290887Safety of perioperative treatment with biologics in patients with inflammatory bowel disease undergoing bowel surgery: Experience from a large urban center.Fabian SchnitzlerCornelia Tillack-SchreiberDaniel SzokodiIsabel BraunJune TomeldenMaximilian SohnFranz BaderConstanze WaggershauserThomas Ochsenkühn<h4>Background and aims</h4>Risks of peri- and postoperative complications after bowel surgery in patients with inflammatory bowel disease (IBD) receiving biologics are still discussed controversially. We therefore addressed the safety of different biologics that were applied in our IBD center before surgery.<h4>Methods</h4>Data of IBD patients who underwent bowel resections between 2012 and 2022 at our hospital were analyzed retrospectively. Exposure to biologics was defined by receiving biologics within 12 weeks before resective abdominal surgery. Safety considerations included minor complications, such as infections and wound healing disorders and major complications, e.g., anastomotic insufficiency or abscess formation.<h4>Results</h4>A total of 447 IBD patients (334 with Crohn's disease, 113 with ulcerative colitis), 51.9% female, were included and followed for a median follow-up of 45 months [range 0-113]. A total of 73.9% (326/447) were undergoing medical treatment at date of surgery, 61.5% (275/447) were treated with biologics within 3 months and 42.3% (189/447) within 4 weeks before surgery. Most surgeries (97.1%) were planned electively and 67.8% were performed laparoscopically. Major and minor complications occurred in 20.8% (93/447) of patients. Serious complications were rare: Six patients had acute postoperative bleeding, one CD patient developed peritonitis and two CD patients died postoperatively. After adjusting for age, disease duration, disease activity, Montreal classification, and medical treatment at date of surgery, no significant differences were observed regarding complications and exposure to biologics.<h4>Conclusions</h4>This retrospective single center study of 447 IBD patients goes to demonstrate that perioperative use of biologics is not associated with a higher risk of complications.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0290887&type=printable |
| spellingShingle | Fabian Schnitzler Cornelia Tillack-Schreiber Daniel Szokodi Isabel Braun June Tomelden Maximilian Sohn Franz Bader Constanze Waggershauser Thomas Ochsenkühn Safety of perioperative treatment with biologics in patients with inflammatory bowel disease undergoing bowel surgery: Experience from a large urban center. PLoS ONE |
| title | Safety of perioperative treatment with biologics in patients with inflammatory bowel disease undergoing bowel surgery: Experience from a large urban center. |
| title_full | Safety of perioperative treatment with biologics in patients with inflammatory bowel disease undergoing bowel surgery: Experience from a large urban center. |
| title_fullStr | Safety of perioperative treatment with biologics in patients with inflammatory bowel disease undergoing bowel surgery: Experience from a large urban center. |
| title_full_unstemmed | Safety of perioperative treatment with biologics in patients with inflammatory bowel disease undergoing bowel surgery: Experience from a large urban center. |
| title_short | Safety of perioperative treatment with biologics in patients with inflammatory bowel disease undergoing bowel surgery: Experience from a large urban center. |
| title_sort | safety of perioperative treatment with biologics in patients with inflammatory bowel disease undergoing bowel surgery experience from a large urban center |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0290887&type=printable |
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