Does infliximab influence surgical morbidity of ileal pouch-anal anastomosis in patients with ulcerative colitis?

Stefanie J. Schluender, Andrew Ippoliti, Marla Dubinsky, Eric A. Vasiliauskas, Konstantinos Papadakis, Ling Mei, Stephan R. Targan, Phillip R. Fleshner

Research output: Contribution to journalArticle

109 Citations (Scopus)

Abstract

PURPOSE: Since infliximab has been approved for treatment of patients with refractory ulcerative colitis, surgeons will be increasingly faced with operating on patients who have failed therapy with this potent immunosuppressant. This study was designed to compare short-term complications in patients with ulcerative colitis who were treated with and without infliximab before colectomy. METHODS: The charts of patients undergoing ileal pouch-anal anastomosis or subtotal colectomy for refractory ulcerative colitis during the five-year period ending October 2005 were reviewed. Postoperative medical and surgical complications were assessed. RESULTS: Seventeen patients had failed infliximab treatment and 134 patients were never treated with infliximab. Ileal pouch-anal anastomosis was performed in 112 patients (74 percent) and subtotal colectomy in 39 patients (36 percent). There were no deaths. Postoperative complications were observed in 43 patients (28 percent), with no significant difference observed between infliximab-treated (37 percent) and infliximab-untreated patients (27 percent). Of 61 patients (40 percent) treated with preoperative cyclosporine A, 5 patients also had been treated with infliximab. The infliximab and cyclosporine A-treated patient group had an 80 percent complication rate, significantly higher than the 29 percent complication rate noted in the cyclosporine A only-treated group (P=0.04). CONCLUSIONS: Although preoperative treatment with infliximab alone does not significantly increase the incidence of postoperative complications, using both inflixiamb and cyclosporine A before colectomy in refractory ulcerative colitis is associated with high surgical morbidity.

Original languageEnglish (US)
Pages (from-to)1747-1753
Number of pages7
JournalDiseases of the Colon and Rectum
Volume50
Issue number11
DOIs
StatePublished - Nov 1 2007
Externally publishedYes

Fingerprint

Colonic Pouches
Ulcerative Colitis
Morbidity
Colectomy
Cyclosporine
Infliximab
Therapeutics
Immunosuppressive Agents

Keywords

  • Colectomy
  • Complications
  • Infliximab
  • Ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Does infliximab influence surgical morbidity of ileal pouch-anal anastomosis in patients with ulcerative colitis? / Schluender, Stefanie J.; Ippoliti, Andrew; Dubinsky, Marla; Vasiliauskas, Eric A.; Papadakis, Konstantinos; Mei, Ling; Targan, Stephan R.; Fleshner, Phillip R.

In: Diseases of the Colon and Rectum, Vol. 50, No. 11, 01.11.2007, p. 1747-1753.

Research output: Contribution to journalArticle

Schluender, SJ, Ippoliti, A, Dubinsky, M, Vasiliauskas, EA, Papadakis, K, Mei, L, Targan, SR & Fleshner, PR 2007, 'Does infliximab influence surgical morbidity of ileal pouch-anal anastomosis in patients with ulcerative colitis?', Diseases of the Colon and Rectum, vol. 50, no. 11, pp. 1747-1753. https://doi.org/10.1007/s10350-007-9008-3
Schluender, Stefanie J. ; Ippoliti, Andrew ; Dubinsky, Marla ; Vasiliauskas, Eric A. ; Papadakis, Konstantinos ; Mei, Ling ; Targan, Stephan R. ; Fleshner, Phillip R. / Does infliximab influence surgical morbidity of ileal pouch-anal anastomosis in patients with ulcerative colitis?. In: Diseases of the Colon and Rectum. 2007 ; Vol. 50, No. 11. pp. 1747-1753.
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AU - Schluender, Stefanie J.

AU - Ippoliti, Andrew

AU - Dubinsky, Marla

AU - Vasiliauskas, Eric A.

AU - Papadakis, Konstantinos

AU - Mei, Ling

AU - Targan, Stephan R.

AU - Fleshner, Phillip R.

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N2 - PURPOSE: Since infliximab has been approved for treatment of patients with refractory ulcerative colitis, surgeons will be increasingly faced with operating on patients who have failed therapy with this potent immunosuppressant. This study was designed to compare short-term complications in patients with ulcerative colitis who were treated with and without infliximab before colectomy. METHODS: The charts of patients undergoing ileal pouch-anal anastomosis or subtotal colectomy for refractory ulcerative colitis during the five-year period ending October 2005 were reviewed. Postoperative medical and surgical complications were assessed. RESULTS: Seventeen patients had failed infliximab treatment and 134 patients were never treated with infliximab. Ileal pouch-anal anastomosis was performed in 112 patients (74 percent) and subtotal colectomy in 39 patients (36 percent). There were no deaths. Postoperative complications were observed in 43 patients (28 percent), with no significant difference observed between infliximab-treated (37 percent) and infliximab-untreated patients (27 percent). Of 61 patients (40 percent) treated with preoperative cyclosporine A, 5 patients also had been treated with infliximab. The infliximab and cyclosporine A-treated patient group had an 80 percent complication rate, significantly higher than the 29 percent complication rate noted in the cyclosporine A only-treated group (P=0.04). CONCLUSIONS: Although preoperative treatment with infliximab alone does not significantly increase the incidence of postoperative complications, using both inflixiamb and cyclosporine A before colectomy in refractory ulcerative colitis is associated with high surgical morbidity.

AB - PURPOSE: Since infliximab has been approved for treatment of patients with refractory ulcerative colitis, surgeons will be increasingly faced with operating on patients who have failed therapy with this potent immunosuppressant. This study was designed to compare short-term complications in patients with ulcerative colitis who were treated with and without infliximab before colectomy. METHODS: The charts of patients undergoing ileal pouch-anal anastomosis or subtotal colectomy for refractory ulcerative colitis during the five-year period ending October 2005 were reviewed. Postoperative medical and surgical complications were assessed. RESULTS: Seventeen patients had failed infliximab treatment and 134 patients were never treated with infliximab. Ileal pouch-anal anastomosis was performed in 112 patients (74 percent) and subtotal colectomy in 39 patients (36 percent). There were no deaths. Postoperative complications were observed in 43 patients (28 percent), with no significant difference observed between infliximab-treated (37 percent) and infliximab-untreated patients (27 percent). Of 61 patients (40 percent) treated with preoperative cyclosporine A, 5 patients also had been treated with infliximab. The infliximab and cyclosporine A-treated patient group had an 80 percent complication rate, significantly higher than the 29 percent complication rate noted in the cyclosporine A only-treated group (P=0.04). CONCLUSIONS: Although preoperative treatment with infliximab alone does not significantly increase the incidence of postoperative complications, using both inflixiamb and cyclosporine A before colectomy in refractory ulcerative colitis is associated with high surgical morbidity.

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