Surgical Outcomes in Vedolizumab-Treated Patients with Ulcerative Colitis

Amy Lightner, Nicholas P. McKenna, Sara Moncrief, John H. Pemberton, Laura E. H. Raffals, Kellie L. Mathis

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

BACKGROUND: Surgical outcomes and pouch outcomes in the setting of vedolizumab remains poorly understood. We sought to determine the rate of 30-day postoperative surgical infectious complications and pouch-specific complications among patients with ulcerative colitis (UC) who received vedolizumab within 12 weeks of surgery.

METHODS: A retrospective chart review between 5/1/2014 and 12/31/2016 of all adult patients with UC who underwent an abdominal operation was performed. Patients with UC who received vedolizumab within 12 weeks of their abdominal operation were compared with patients with UC on anti-TNFα treatment.

RESULTS: Eighty-eight patients received vedolizumab and 62 received anti-TNFα within 12 weeks of surgery. More vedolizumab-treated patients had superficial surgical site infections (P = 0.047) and mucocutaneous separation at the ileostomy (P = 0.047), but there was no difference in the overall surgical infectious complication rate, deep space SSI, 30-day hospital readmission or return to the operating room. On univariate analysis of SSI among patients with UC, exposure to vedolizumab was not a significant predictor of SSI (P = 0.27), but steroids were predictive of SSI on univariate (P = 0.02) and multivariable analysis (P = 0.02). After ileal pouch anal anastomosis, there was a higher rate of intra-abdominal abscesses (31.3% versus 5.9%) and mucocutaneous separation (18.8% versus 0%) in the vedolizumab group compared with the anti-TNFα group, but statistical significance was not reached.

CONCLUSIONS: Vedolizumab patients had significantly increased rates of superficial SSI, but not overall infectious complications. Among ileal pouch anal anastomosis patients, peripouch abscess rates were increased among vedolizumab-treated patients, but this did not reach statistical significance. Vedolizumab seems safe in the perioperative period for patients with UC.

Original languageEnglish (US)
Pages (from-to)2197-2201
Number of pages5
JournalInflammatory Bowel Diseases
Volume23
Issue number12
DOIs
StatePublished - Dec 1 2017

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Ulcerative Colitis
Colonic Pouches
vedolizumab
Abdominal Abscess
Surgical Wound Infection
Patient Readmission
Ileostomy
Perioperative Period
Operating Rooms
Abscess
Steroids

ASJC Scopus subject areas

  • Immunology and Allergy
  • Gastroenterology

Cite this

Lightner, A., McKenna, N. P., Moncrief, S., Pemberton, J. H., Raffals, L. E. H., & Mathis, K. L. (2017). Surgical Outcomes in Vedolizumab-Treated Patients with Ulcerative Colitis. Inflammatory Bowel Diseases, 23(12), 2197-2201. https://doi.org/10.1097/MIB.0000000000001248

Surgical Outcomes in Vedolizumab-Treated Patients with Ulcerative Colitis. / Lightner, Amy; McKenna, Nicholas P.; Moncrief, Sara; Pemberton, John H.; Raffals, Laura E. H.; Mathis, Kellie L.

In: Inflammatory Bowel Diseases, Vol. 23, No. 12, 01.12.2017, p. 2197-2201.

Research output: Contribution to journalArticle

Lightner, A, McKenna, NP, Moncrief, S, Pemberton, JH, Raffals, LEH & Mathis, KL 2017, 'Surgical Outcomes in Vedolizumab-Treated Patients with Ulcerative Colitis', Inflammatory Bowel Diseases, vol. 23, no. 12, pp. 2197-2201. https://doi.org/10.1097/MIB.0000000000001248
Lightner, Amy ; McKenna, Nicholas P. ; Moncrief, Sara ; Pemberton, John H. ; Raffals, Laura E. H. ; Mathis, Kellie L. / Surgical Outcomes in Vedolizumab-Treated Patients with Ulcerative Colitis. In: Inflammatory Bowel Diseases. 2017 ; Vol. 23, No. 12. pp. 2197-2201.
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abstract = "BACKGROUND: Surgical outcomes and pouch outcomes in the setting of vedolizumab remains poorly understood. We sought to determine the rate of 30-day postoperative surgical infectious complications and pouch-specific complications among patients with ulcerative colitis (UC) who received vedolizumab within 12 weeks of surgery.METHODS: A retrospective chart review between 5/1/2014 and 12/31/2016 of all adult patients with UC who underwent an abdominal operation was performed. Patients with UC who received vedolizumab within 12 weeks of their abdominal operation were compared with patients with UC on anti-TNFα treatment.RESULTS: Eighty-eight patients received vedolizumab and 62 received anti-TNFα within 12 weeks of surgery. More vedolizumab-treated patients had superficial surgical site infections (P = 0.047) and mucocutaneous separation at the ileostomy (P = 0.047), but there was no difference in the overall surgical infectious complication rate, deep space SSI, 30-day hospital readmission or return to the operating room. On univariate analysis of SSI among patients with UC, exposure to vedolizumab was not a significant predictor of SSI (P = 0.27), but steroids were predictive of SSI on univariate (P = 0.02) and multivariable analysis (P = 0.02). After ileal pouch anal anastomosis, there was a higher rate of intra-abdominal abscesses (31.3{\%} versus 5.9{\%}) and mucocutaneous separation (18.8{\%} versus 0{\%}) in the vedolizumab group compared with the anti-TNFα group, but statistical significance was not reached.CONCLUSIONS: Vedolizumab patients had significantly increased rates of superficial SSI, but not overall infectious complications. Among ileal pouch anal anastomosis patients, peripouch abscess rates were increased among vedolizumab-treated patients, but this did not reach statistical significance. Vedolizumab seems safe in the perioperative period for patients with UC.",
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AB - BACKGROUND: Surgical outcomes and pouch outcomes in the setting of vedolizumab remains poorly understood. We sought to determine the rate of 30-day postoperative surgical infectious complications and pouch-specific complications among patients with ulcerative colitis (UC) who received vedolizumab within 12 weeks of surgery.METHODS: A retrospective chart review between 5/1/2014 and 12/31/2016 of all adult patients with UC who underwent an abdominal operation was performed. Patients with UC who received vedolizumab within 12 weeks of their abdominal operation were compared with patients with UC on anti-TNFα treatment.RESULTS: Eighty-eight patients received vedolizumab and 62 received anti-TNFα within 12 weeks of surgery. More vedolizumab-treated patients had superficial surgical site infections (P = 0.047) and mucocutaneous separation at the ileostomy (P = 0.047), but there was no difference in the overall surgical infectious complication rate, deep space SSI, 30-day hospital readmission or return to the operating room. On univariate analysis of SSI among patients with UC, exposure to vedolizumab was not a significant predictor of SSI (P = 0.27), but steroids were predictive of SSI on univariate (P = 0.02) and multivariable analysis (P = 0.02). After ileal pouch anal anastomosis, there was a higher rate of intra-abdominal abscesses (31.3% versus 5.9%) and mucocutaneous separation (18.8% versus 0%) in the vedolizumab group compared with the anti-TNFα group, but statistical significance was not reached.CONCLUSIONS: Vedolizumab patients had significantly increased rates of superficial SSI, but not overall infectious complications. Among ileal pouch anal anastomosis patients, peripouch abscess rates were increased among vedolizumab-treated patients, but this did not reach statistical significance. Vedolizumab seems safe in the perioperative period for patients with UC.

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