The impact of infliximab on the postoperative course of patients with IBD is under debate.
The aim of this study was to evaluate the influence of infliximab on perioperative outcomes in patients undergoing elective laparoscopic resection for IBD.
This study is a retrospective analysis of a prospectively collected, institutional review board-approved database.
Patients undergoing laparoscopic resection on preoperative infliximab (infliximab group) were compared with patients who did not receive infliximab (noninfliximab group).
The short-term and long-term morbidity and mortality rates were assessed.
Elective laparoscopic resection for IBD was performed on 518 patients from January 2004 through June 2011; 142 patients were treated with infliximab preoperatively. Both groups had similar demographics, type and severity of IBD, comorbidities, and type of surgery. A significantly higher number of patients in the infliximab group had been on aggressive medical therapy to control symptoms of IBD during the month preceding surgery, including steroids (73.9 vs 58.8%, p = 0.002) and immunosuppressors (32.4 vs 20.5%, p = 0.006). Operative time and blood loss were similar (p = 0.50 and p = 0.34). Intraoperative complication rate was 2.1% in both groups. No significant differences were observed in terms of the conversion rate to laparotomy (6.3% vs 9.3%, p = 0.36), overall 30-day postoperative morbidity (p = 0.93), or mortality (p = 0.61). The rates of anastomotic leak (2.1% vs 1.3%, p = 0.81), infections (12% vs 11.2%, p = 0.92), and thrombotic complications (3.5% vs 5.6%, p = 0.46) were similar. Subgroup analyses confirmed similar rates of overall, infectious, and thrombotic complications regardless of whether patients had ulcerative colitis or Crohn’s disease.
This study is subject to the limitations of a retrospective design.
Infliximab is not associated with increased rates of postoperative complications after laparoscopic resection.
Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois
Financial Disclosure: None reported.
Correspondence: Alessandro Fichera, M.D., University of Washington Medical Center, 1959 NE Pacific St, Box 356410, Room BB-414, Seattle, WA 98195. E-mail: email@example.com