Long Time from Diagnosis to Surgery May Increase Postoperative Complication Rates in Elective CD Intestinal Resections: An Observational Study

Gastroenterol Res Pract. 2018 Apr 23:2018:4703281. doi: 10.1155/2018/4703281. eCollection 2018.

Abstract

Background: There is lack of data analyzing short-term postoperative complications and time from diagnosis to surgery in Crohn's disease (CD).

Aim: To compare complication rates after elective abdominal operations in CD patients with different durations of disease.

Methods: Retrospective observational study with CD patients who submitted to elective intestinal resections. Patients were allocated in 2 groups according to time to surgery (TS) in less or more than 5 years. Short-term postoperative complications were analyzed and compared between the 2 groups, and binary logistic regression analysis was performed to check for significant variables.

Results: 123 patients were finally included, 77 with TS > 5 years (62.6%) and 46 with TS < 5 years (37.4%). Patients with TS > 5 years had higher rates of overall surgical complications (p = 0.011), reoperations (p = 0.003), surgical site infections (p = 0.014), anastomotic dehiscence (p = 0.021), abdominal abscesses (p = 0.021), and overall medical complications (p = 0.019). On logistic regression, the single significant variable was the confection of stomas (OR: 3.203; 95% CI: 1.011-10.151; p = 0.048).

Conclusions: Patients with longer time to surgery showed a significant increase in overall medical and surgical postoperative early complications after elective intestinal resections.