The Effect of Biologics on Post-Operative Complications in Children with Inflammatory Bowel Disease and Bowel Resection

Objectives: There has been limited investigation of pediatric patients with inflammatory bowel disease (IBD) who have been treated with biologic agents and undergo operative management. Post-operative complications in the adult setting have been mixed and in the pediatric population the data has been limited. This study compares children with IBD treated with biologic agents to patients treated with non-biologic therapy prior to bowel resection. Methods: This is a single center, retrospective chart review study of 62 children with IBD who underwent bowel resection between 2001 and 2017. Analysis included patient demographics, medications used prior to surgery, incidence of postoperative complications, indication for surgery, type of operation, and additional surgeries required. Post-operative complications were defined as superficial skin infection, leak at anastomotic site, intra-abdominal abscess, wound dehiscence, etc. Complications were compared based on medical therapy. Results: Of the 62 children reviewed, 21 carried the diagnosis of ulcerative colitis (UC), 40 had Crohn's disease (CD), and 1 had IBD-unspecified. Thirty-seven of the patients were treated with infliximab, adalimumab, or vedolizumab prior to their bowel resection. There were four complications documented within 30 days of the operation, with an overall complication rate of 6.45 percent. There were two complications in each of the cohorts, including intra-abdominal abscess (2), abdominal wall abscess (1), and pouchitis (1). Conclusion: The number of complications was the same between those who did and did not receive a preoperative biologic agent. This study suggests that biologics may be safe to use in patients undergoing bowel resection. Address correspondence and reprint requests to Mohammad El-Baba, MD. Children's Hospital of Michigan; Division of Pediatric Gastroenterology; 3901 Beaubien Blvd, Detroit, MI 48201 (e-mail: melbaba@dmc.org) Received 13 June, 2018 Accepted 9 September, 2018 Conflicts of Interest and Sources of Funding: There was no funding for this study. JBM: No conflict to disclose. RG: No conflict to disclose. RT: No conflict to disclose. ME: No conflict to disclose. © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2zmiROP
via IFTTT