Watchful Waiting After Radiological Guided Drainage of Intra-abdominal Abscess in Patients With Crohn’s Disease Might Be Associated With Increased Rates of Stoma Construction

Author:

El-Hussuna Alaa1ORCID,Steenholdt Casper2,Merrild Karer Mette Louise3,Nyggard Uldall Nielsen Natasja3,Mujukian Angela4,Fleshner Phillip R4,Iesalnieks Igors5,Horesh Nir6ORCID,Kopylov Uri6ORCID,Jacoby Harel6,Alqaisi Hayder Mahmood Waheeb7ORCID,Colombo Francesco8,Sampietro Gianluca M89,Marino Marco V10ORCID,Ellebæk Mark11,Sørensen Nina7,Celentano Valerio12,Ladwa Nikhil13,Warusavitarne Janindra13ORCID,Pellino Gianluca1415,Zeb Aurang16,Di Candido Francesca17,Hurtado-Pardo Luis18ORCID,Frasson Matteo18ORCID,Kunovsky Lumir192021ORCID,Yalcinkaya Ali22,Alonso Sandra23,Pera Miguel23,Rodríguez Cristina Antón24,Bravo Ana-Minaya2425,Granero Alvaro Garcia26,Tatar Ozan Can27,Spinelli Antonino17,Qvist Niels11ORCID

Affiliation:

1. OpenSourceResearch Collaboration , Aalborg , Denmark

2. Department of Gastroenterology, Herlev Hospital , Herlev , Denmark

3. Department of Surgery, Aalborg University , Aalborg , Denmark

4. Department of Surgery, Cedars-Sinai Medical Center , Los Angeles, California , USA

5. Department of Surgery, Städtisches Klinikum München Bogenhausen , Munich , Germany

6. Sheba Medical Center, Sackler Medical School Tel Aviv University , Ramat Gan , Israel

7. Department of Surgery, Aalborg University Hospital , Aalborg , Denmark

8. Division of General and HPB Surgery, Luigi Sacco Hospital , Milano , Italy

9. Surgery, Università degli Studi di Milano , Milan , Italy

10. Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello , Palermo , Italy

11. Research Unit for Surgery and IBD-Care, Odense University Hospital, University of Southern Denmark , Odense , Denmark

12. Chelsea and Westminster Hospital NHS Foundation Trust , London , UK

13. Department of Surgery, St Mark’s and Northwick Park Hospital , London , UK

14. Colorectal Surgery, Vall d’Hebron University Hospital , Barcelona , Spain

15. Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli,”   Naples , Italy

16. Department of Surgery, Hvidovre Hospital , Hvidovre , Denmark

17. Department of Biomedical Sciences, IRCCS Humanitas Research Hospital, Humanitas University , Milan , Italy

18. Department of Surgery, University Hospital La Fe, University of Valencia , Spain

19. Department of Surgery, Faculty of Medicine, University Hospital Brno, Masaryk University , Brno , Czech Republic

20. Department of Gastroenterology and Digestive Endoscopy, Masaryk Memorial Cancer Institute , Brno , Czech Republic

21. Department of Internal Medicine – Gastroenterology and Geriatrics, University Hospital Olomouc, Faculty of Medicine and Dentistry , Palacky University Olomouc, Olomouc , Czech Republic

22. Faculty of Medicine, Gazi University , Ankara , Turkey

23. Department of Surgery, Hospital del Mar , Spain

24. Medicine Faculty, Universidad Francisco de Vitoria , Madrid , Spain

25. Colorectal Surgery Unit, Hospital Universitario , Madrid Del Henares , Spain

26. Colorectal Surgery Unit, Hospital Universitario Son Espases , Mallorca , Spain

27. School of Medicine, Kocaeli University , Kocaeli , Turkey

Abstract

Abstract Background Management of spontaneous intra-abdominal abscess (IAA) in patients with Crohn’s disease (CD) with radiologically guided percutaneous drainage (PD) was debated. Methods This is a secondary analysis from a multicenter, retrospective cohort study of all the patients with CD who underwent PD followed by surgery at 19 international tertiary centers. Results Seventeen patients (4.8%) who did not undergo surgery after PD were compared to those who had PD followed by surgical intervention 335/352 (95.2%). Patients who had PD without surgery were those with longer disease duration, more frequently had previous surgery for CD (laparotomies/laparoscopies), enteric fistula, on steroid treatment before and continue to have it after PD. Patients who had PD without subsequent surgical resection had a higher risk of stoma construction at later stages 8/17 (47.1%) versus 90/326 (27.6%) (P < .01). Patients with PD with no subsequent surgery had numerically higher rates of abscess recurrence 5/17 (29.4%) compared to those who had PD followed by surgery 45/335 (13.4%) the difference was not statistically significant (P = .07). Conclusions Even with the low number of patients enrolled in this study who had PD of IAA without subsequent surgery, the findings indicate a markedly worse prognosis in terms of recurrence, length of stay, readmission, and stoma construction. Watchful waiting after PD to treat patients with spontaneous IAA might be indicated in selected patients with poor health status or poor prognostic factors.

Publisher

Oxford University Press (OUP)

Subject

Gastroenterology

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3