1. Patients with Crohn's disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications' rate
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Dich Grandt, S, El-Hussuna, A, Frasson, M, Singh, B, Gallo, G, Pata, F, Negoi, I, Pinkney, T, Zmora, O, Bhangu, A, Battersby, N, Chaudhri, S, Nepogodiev, D, Vennix, S, Glasbey, J, Minaya, A, Basso, L, Pukuotukai, M, Kelly, Me, Sánchez Guillén, L, Pellino, G, Buchs, N, Morton, D, Bemelman, W, Christensen, P, D'Hoore, A, Laurberg, S, Rubbini, M, Vaizey, C, Magill, L, Perry, R, Sheward, N, Mortensen, Rn, Cillo, M, Estefania, D, Patron Uriburu, J, Ruiz, H, Salomon, M, Makhmudov, A, Selnyahina, L, Varabei, A, Vizhynis, Y, Claeys, D, Defoort, B, Muysoms, F, Pletinckx, P, Vergucht, V, Debergh, I, Feryn, T, Reusens, H, Francart, D, Jehaes, C, Markiewicz, S, Monami, B, Weerts, J, Bouckaert, W, Houben, B, Knol, J, Sergeant, G, Vangertruyden, G, Haeck, L, Lange, C, Sommeling, C, Vindevoghel, K, Castro, S, De Bruyn, H, Huyghe, M, De Wolf, E, Reynders, D, de Buck van Overstraeten, A, Wolthuis, A, Delibegovic, S, Christiani, A, Marchiori, M Jr, Rocha de Moraes, C, Tercioti, V Jr, Arabadjieva, E, 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Crohn’s disease ,medicine.medical_specialty ,Complications ,Colorectal cancer ,SURGERY ,medicine.medical_treatment ,Bowel resection ,Disease ,Inflammatory bowel disease ,NO ,COLORECTAL-CANCER ,03 medical and health sciences ,Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] ,MORBIDITY ,0302 clinical medicine ,Medicine ,Crohn’s disease, Colon cancer, Complications, Length of stay, Bowel resection, Right hemicolectomy ,DIVERTICULAR-DISEASE ,Colon cancer ,Length of stay ,Right hemicolectomy ,colon cancer ,complications ,length of stay ,bowel resection ,right hemicolectomy ,PREOPERATIVE OPTIMIZATION ,RISK ,Crohn's disease ,ddc:617 ,business.industry ,medicine.disease ,3126 Surgery, anesthesiology, intensive care, radiology ,digestive system diseases ,Surgery ,030220 oncology & carcinogenesis ,3121 General medicine, internal medicine and other clinical medicine ,Diverticular disease ,Prospective Study ,030211 gastroenterology & hepatology ,SMOKING ,business ,Complication ,Hospital stay ,INFLAMMATORY-BOWEL-DISEASE - Abstract
BACKGROUND: Right hemicolectomy or ileocecal resection are used to treat benign conditions like Crohn's disease (CD) and malignant ones like colon cancer (CC).AIM: To investigate differences in pre- and peri-operative factors and their impact on post-operative outcome in patients with CC and CD.METHODS: This is a sub-group analysis of the European Society of Coloproctology's prospective, multi-centre snapshot audit. Adult patients with CC and CD undergoing right hemicolectomy or ileocecal resection were included. Primary outcome measure was 30-d post-operative complications. Secondary outcome measures were post-operative length of stay (LOS) at and readmission.RESULTS: Three hundred and seventy-five patients with CD and 2,515 patients with CC were included. Patients with CD were younger (median = 37 years for CD and 71 years for CC (P < 0.01), had lower American Society of Anesthesiology score (ASA) grade (P < 0.01) and less comorbidity (P < 0.01), but were more likely to be current smokers (P < 0.01). Patients with CD were more frequently operated on by colorectal surgeons (P < 0.01) and frequently underwent ileocecal resection (P < 0.01) with higher rate of de-functioning/primary stoma construction (P < 0.01). Thirty-day post-operative mortality occurred exclusively in the CC group (66/2515, 2.3%). In multivariate analyses, the risk of post-operative complications was similar in the two groups (OR 0.80, 95%CI: 0.54-1.17; P = 0.25). Patients with CD had a significantly longer LOS (Geometric mean 0.87, 95%CI: 0.79-0.95; P < 0.01). There was no difference in re-admission rates. The audit did not collect data on post-operative enhanced recovery protocols that are implemented in the different participating centers.CONCLUSION: Patients with CD were younger, with lower ASA grade, less comorbidity, operated on by experienced surgeons and underwent less radical resection but had a longer LOS than patients with CC although complications' rate was not different between the two groups.
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- 2019
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