Outcomes after right-sided colon surgery in Crohn’s disease versus cancer

• Published in: Techniques in coloproctology 2024-12, Vol.28 (1), p.116, Article 116
• Main Authors: Choi, B., Church, J., Khoshknabi, D., Jabi, O., Kiran, R. P.
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adult; Aged; Anastomosis, Surgical - adverse effects; Anastomosis, Surgical - methods; Cancer; Colectomy - adverse effects; Colectomy - methods; Colon - surgery; Colonic Neoplasms - mortality; Colonic Neoplasms - surgery; Colorectal Surgery; Comparative advantage; Crohn Disease - complications; Crohn Disease - surgery; Crohn's disease; Female; Gastroenterology; Humans; Ileum - surgery; Intraoperative Complications - etiology; Laparoscopy; Laparoscopy - adverse effects; Laparoscopy - methods; Laparoscopy - statistics & numerical data; Length of stay; Length of Stay - statistics & numerical data; Male; Medicine; Medicine & Public Health; Middle Aged; Mortality; Original Article; Patient Readmission - statistics & numerical data; Perioperative care; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative period; Proctology; Reoperation - statistics & numerical data; Retrospective Studies; Surgery; Surgical outcomes; Treatment Outcome
• ISSN: 1123-6337; 1128-045X; 1128-045X
• DOI: 10.1007/s10151-024-02962-y

Background Surgery for Crohn’s disease (CD) is considered to have more complications due to the underlying inflammation, immunosuppression, and malnutrition. We sought to study the outcomes of right-sided colonic resection in patients with CD and patients with cancer at a high-volume tertiary center utilizing a standardized perioperative protocol. Methods This is a retrospective study of outcomes for all patients with CD or patients undergoing ileocolic resection or right hemicolectomy with ileocolic anastomosis at a single institution from 2013 to 2022. Patients were excluded if they simultaneously underwent another procedure or ostomy creation. Data were analyzed using Wilcoxon rank-sum and chi-squared tests for univariate analyses, and logistic and linear regressions for multivariate analyses. Results In total 141 patients with CD and 589 patients with cancer were included. Patients with CD were significantly younger with lower body mass index and less likely to have comorbidities, including diabetes and hypertension. Patients with CD were less likely to have a smoking history or prior abdominal surgery, but more likely to be on steroids. Both groups had similar rates of laparoscopy, intraoperative complications, and blood loss. Despite the preoperative and intraoperative differences, both patients with CD and patients with cancer had similar lengths of stay (LOS), readmission, reoperation, and mortality rates. None of the surgical outcomes differed significantly between the two groups. On multivariate analysis, CD diagnosis was not associated with reoperation, readmission, mortality, or LOS while controlling for other characteristics. Conclusions With the use of standardized perioperative protocols, surgery for CD at a high-volume center with expertise in CD can be performed with comparable results to other indications like cancer.