J 2023

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

EL-HUSSUNA, Alaa, Casper STEENHOLDT, Mette Louise Merrild KARER, Natasja Nyggard Uldall NIELSEN, Angela MUJUKIAN et. al.

Basic information

Original name

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

Authors

EL-HUSSUNA, Alaa, Casper STEENHOLDT, Mette Louise Merrild KARER, Natasja Nyggard Uldall NIELSEN, Angela MUJUKIAN, Phillip R FLESHNER, Igors IESALNIEKS, Nir HORESH, Uri KOPYLOV, Harel JACOBY, Haider Mahmoud AL-QAISI, Francesco COLOMBO, Gianluca M SAMPIETRO, Marco V MARINO, Mark ELLEBÆK, Nina SØRENSEN, Valerio CELENTANO, Nikhil LADWA, Janindra WARUSAVITARNE, Gianluca PELLINO, Aurang ZEB, Francesca Di CANDIDO, Luis HURTADO-PARDO, Matteo FRASSON, Lumír KUNOVSKÝ (203 Czech Republic, belonging to the institution), Ali YALCINKAYA, Sandra ALONSO, Miguel PERA, Cristina Antón RODRÍGUEZ, Bravo ANA-MINAYA, Alvaro Garcia GRANERO, Ozan Can TATAR, Antonino SPINELLI and Niels QVIST

Edition

Crohn's & colitis 360, OXFORD, OXFORD UNIV PRESS, 2023, 2631-827X

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30212 Surgery

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 1.400 in 2022

RIV identification code

RIV/00216224:14110/23:00131653

Organization unit

Faculty of Medicine

UT WoS

001186353800001

Keywords in English

Crohn’s disease; abscess; surgery; complications; stoma

Tags

Tags

International impact, Reviewed
Změněno: 2/4/2024 07:32, Mgr. Tereza Miškechová

Abstract

V originále

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.