Preoperative Infliximab is not Associated with an Increased Risk of Short-Term Postoperative Complications After Restorative Proctocolectomy and Ileal Pouch-Anal Anastomosis

Academic Article

Abstract

  • Introduction: Considerable controversy exists over whether the preoperative use of infliximab (IFX) for refractory ulcerative colitis (UC) increases the risk for surgical complications after restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA). The aim of this study was to assess the association between preoperative IFX use and short-term surgical complications in a single-surgeon cohort at a tertiary care academic center. Methods: UC patients who underwent IPAA from September 2005 through May 2009 were retrospectively identified. Twenty-nine patients treated with IFX within 12 weeks of surgery and 52 non-IFX control subjects were identified. Short-term postoperative outcomes were compared between groups occurring within 30 days of loop ileostomy closure. Results: Patients were similar with respect to demographics, co-morbidities, rate of emergency surgery, hand-sewn anastomosis, and preoperative use of cyclosporine, azathioprine, and high-dose steroids. IFX patients were more likely to have received a laparoscopic hand-assisted IPAA, low-, medium-, and any-dose steroids, 6-mercaptopurine (6-MP), methotrexate, and to have failed medical therapy. There was no short-term mortality. Overall postoperative and infectious complications were similar between IFX and non-IFX groups. Multivariate regression models revealed no independent predictors for postoperative complications when including IFX [odds ratio (OR) 0. 78, p = 0. 67], laparoscopic hand-assisted IPAA, 6-MP, methotrexate, steroids, failure of medical therapy, and body mass index. Conclusions: Preoperative IFX use was not associated with an increased risk of short-term postoperative complications after IPAA. © 2011 The Society for Surgery of the Alimentary Tract.
  • Authors

    Digital Object Identifier (doi)

    Pubmed Id

  • 3289794
  • Author List

  • Gainsbury ML; Chu DI; Howard LA; Coukos JA; Farraye FA; Stucchi AF; Becker JM
  • Start Page

  • 397
  • End Page

  • 403
  • Volume

  • 15
  • Issue

  • 3