Effect of Anti-TNF Agents on Postoperative Outcomes in Inflammatory Bowel Disease Patients: a Single Institution Experience

• Published in: Journal of gastrointestinal surgery 2016-09, Vol.20 (9), p.1636-1642
• Main Authors: Shwaartz, Chaya, Fields, Adam C., Sobrero, Maximiliano, Cohen, Brian D., Divino, Celia M.
• Format: Article
• Language: English
• Subjects: 2016 SSAT Poster Presentation; Abdominal Abscess - epidemiology; Adalimumab - therapeutic use; Adult; Anastomotic Leak - epidemiology; Certolizumab Pegol - therapeutic use; Female; Gastroenterology; Gastrointestinal Agents - therapeutic use; Humans; Inflammatory bowel disease; Inflammatory Bowel Diseases - drug therapy; Inflammatory Bowel Diseases - surgery; Infliximab - therapeutic use; Male; Medicine; Medicine & Public Health; Middle Aged; Patient Readmission - statistics & numerical data; Postoperative Period; Retrospective Studies; Surgery; Surgical Wound Infection - epidemiology; Survival Rate; Treatment Outcome; Tumor Necrosis Factor-alpha - antagonists & inhibitors; Young Adult
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-016-3194-z

Background Anti-tumor necrosis factor (TNF) agents have been an integral part in the treatment of inflammatory bowel disease. However, a subset of inflammatory bowel disease patients ultimately requires surgery and up to 30 % of them have undergone treatment with anti-TNF agents. Studies assessing the effect of anti-TNF agents on postoperative outcomes have been inconsistent. The aim of this study is to assess postoperative morbidity in inflammatory bowel disease patients who underwent surgery with anti-TNF therapy prior to surgery. Methods This is a retrospective review of 282 patients with inflammatory bowel disease undergoing intestinal surgery between 2013 and 2015 at the Mount Sinai Hospital. Patients were divided into two groups based on treatment with anti-TNF agents (infliximab, adalimumab, certolizumab) within 8 weeks of surgery. Thirty-day postoperative outcomes were recorded. Univariate and multivariate statistical analyses were carried out. Results Seventy-three patients were treated with anti-TNF therapy within 8 weeks of surgery while 209 patients did not have exposure. Thirty-day anastomotic leak, intra-abdominal abscess, wound infection, extra-abdominal infection, readmission, and mortality rates were not significantly different between the two groups. Conclusions The use of anti-TNF medications in inflammatory bowel disease patients within 2 months of intestinal surgery is not associated with an increased risk of 30-day postoperative complications.