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The importance of the Crohn's disease activity index in surgery for small bowel Crohn's disease.

Authors
  • Lee, J-S1
  • Kim, H-J1
  • Cho, H-M1
  • Lee, K-M2
  • Kye, B-H3
  • 1 Department of Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea. , (North Korea)
  • 2 Department of Gastroenterology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea. , (North Korea)
  • 3 Department of Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea. Electronic address: [email protected] , (North Korea)
Type
Published Article
Journal
Journal of Visceral Surgery
Publisher
Elsevier
Publication Date
Nov 01, 2016
Volume
153
Issue
5
Pages
339–345
Identifiers
DOI: 10.1016/j.jviscsurg.2016.04.009
PMID: 27179763
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Compared with patients with other benign intestinal conditions, patients with CD are at increased risk of developing postoperative complications following intestinal resection. We searched for useful tools for predicting postoperative complication in patients with CD by comparing the relationship between postoperative morbidity in these patients as measured by three different scoring tools: general surgical risk (POSSUM score), disease activity (CDAI), and nutritional screening (nutritional prognostic index). We performed a retrospective review of 50 patients with small bowel CD who underwent surgical resection and primary anastomosis between 1999 and 2014. This study enrolled 34 men and 16 women. The mean age was 38.4 years (range: 20-81 years). There was no postoperative mortality. The overall postoperative morbidity rate (33.7%) predicted by POSSUM was similar to the rate in the study patients (36.0%). Although POSSUM score predicted higher postoperative morbidity rates in patients who underwent emergency surgery (estimated morbidity: 52.8%), the actual postoperative morbidity rate in the emergency surgery group (26.7%) was smaller than in the elective surgery group (40.0%). In addition, neither preoperative nutritional status nor POSSUM score was related to the severity of postoperative complications. CDAI score was significantly related to the severity of postoperative complications (P=0.032). Based on the above results, a high preoperative CDAI score can predict negative postoperative outcomes. We believe that disease activity should be controlled using various treatment modalities, such as enteral or total parenteral nutrition as well as medication, before performing surgery in patients with CD. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

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