Patients with Crohn's disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications' rate

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dc.contributor.author Alonso, N.
dc.contributor.author Ambrona Zafra, D.
dc.contributor.author Ayala Candia, B.A.
dc.contributor.author Bonnin Pascual, J.
dc.contributor.author Pineño Flores, C.
dc.date.accessioned 2020-09-28T11:38:57Z
dc.date.available 2020-09-28T11:38:57Z
dc.identifier.uri http://hdl.handle.net/11201/153590
dc.description.abstract [eng] BACKGROUND Right hemicolectomy or ileocecal resection are used to treat benign conditions like Crohn's disease (CD) and malignant ones like colon cancer (CC). AIM To investigate differences in pre- and peri-operative factors and their impact on post-operative outcome in patients with CC and CD. METHODS This is a sub-group analysis of the European Society of Coloproctology's prospective, multi-centre snapshot audit. Adult patients with CC and CD undergoing right hemicolectomy or ileocecal resection were included. Primary outcome measure was 30-d post-operative complications. Secondary outcome measures were post-operative length of stay (LOS) at and readmission. RESULTS Three hundred and seventy-five patients with CD and 2,515 patients with CC were included. Patients with CD were younger (median = 37 years for CD and 71 years for CC (P < 0.01), had lower American Society of Anesthesiology score (ASA) grade (P < 0.01) and less comorbidity (P < 0.01), but were more likely to be current smokers (P < 0.01). Patients with CD were more frequently operated on by colorectal surgeons (P < 0.01) and frequently underwent ileocecal resection (P < 0.01) with higher rate of de-functioning/primary stoma construction (P < 0.01). Thirty-day post-operative mortality occurred exclusively in the CC group (66/2515, 2.3%). In multivariate analyses, the risk of post-operative complications was similar in the two groups (OR 0.80, 95%CI: 0.54-1.17; P = 0.25). Patients with CD had a significantly longer LOS (Geometric mean 0.87, 95%CI: 0.79-0.95; P < 0.01). There was no difference in re-admission rates. The audit did not collect data on post-operative enhanced recovery protocols that are implemented in the different participating centers CONCLUSION Patients with CD were younger, with lower ASA grade, less comorbidity, operated on by experienced surgeons and underwent less radical resection but had a longer LOS than patients with CC although complications' rate was not different between the two groups
dc.format application/pdf
dc.relation.isformatof https://doi.org/10.4240/wjgs.v11.i5.261
dc.relation.ispartof World Journal of Gastrointestinal Surgery, 2019, vol. 11, num. 5, p. 261-270
dc.rights , 2019
dc.subject.classification 61 - Medicina
dc.subject.classification 617 - Cirurgia. Ortopèdia. Oftalmologia
dc.subject.other 61 - Medical sciences
dc.subject.other 617 - Surgery. Orthopaedics. Ophthalmology
dc.title Patients with Crohn's disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications' rate
dc.type info:eu-repo/semantics/article
dc.date.updated 2020-09-28T11:38:57Z
dc.subject.keywords malaltia de Crohn
dc.subject.keywords cancer de colon
dc.subject.keywords Morbilidad
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.identifier.doi https://doi.org/10.4240/wjgs.v11.i5.261


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