Risk factors for postoperative complications after surgery in complicated Crohn’s disease

Abstract

Aim: to improve results of the surgical treatment of Crohn’s disease. Patients and Methods: 162 patients were included. 69 (42,6 %) — received preoperative conservative treatment. Ileocecal resection was performed in 148 (91,4 %), in 5 (3,1 %) cases — part of jejunum resection, ileum resection — in 3 (1,8 %) patients and right hemicolectomy — 6 (3,7 %). Stoma formation was in 104 (64,2 %) patients. Complications were registered in 25 (15,4 %) cases. Results: in univariant analysis it was found that young age up to 40 years, male gender and short operative time ( 150 min) are the predictors (р = 0,03, р = 0,03 и р = 0,02, respectively) to noncomplicated postoperative period (reduce risk in 10, 5 и 10 fold, respectively). The absence of conservative treatment before surgery increased the complications’ rate more than 3 times comparing to patients who received therapy (OR 3,2 CI 95 % 0,1–11,45; р = 0,06), but we failed to get significance, that is why multivariant analysis was carried out to see the influence of all clinical factors on non-treated patients. Significance was found in all models. Conclusion: male gender (OR 0,2 CI 95 % 0,01–2,02; р = 0,02), the age younger than 40 (OR 0,1 CI 95 % 0,02–0,9; р = 0,03) and the duration of the operation less than 150 minutes (OR 0,1 CI 95 % 0,01–2,02; р = 0,03) is associated with the reduction of complications in the postoperative period. Preoperative conservative treatment during 3 months allows to decrease the rate of complications to 3,5 times (OR 3,5 CI 95 % 1,2–9,8; р = 0,01) and risk of the stoma formation — to 7 times (χ2 = 7,56; р = 0,006).