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Outcomes of early ileocolectomy after percutaneous drainage for perforated ileocolic Crohn's disease
- Source :
- The American Journal of Surgery. 212:728-734
- Publication Year :
- 2016
- Publisher :
- Elsevier BV, 2016.
-
Abstract
- Background The optimal treatment for an intra-abdominal abscess/infection secondary to perforating ileocolic Crohn's disease (PCD) is unclear. Methods Forty-seven consecutive PCD patients treated via an institutional protocol of ileocolectomy after a 7-day period of percutaneous abscess drainage were retrospectively compared with 160 consecutive patients who underwent an elective ileocolectomy for Crohn's disease (ECD) between 1992 and 2014. Outcomes were compared using univariate analysis and propensity score matching. Results Univariate analysis demonstrated significant differences in ileostomy rates (PCD: 48.9% vs ECD: 18.8%; P = .001), 30-day readmissions (PCD: 38.3% vs ECD: 18.8%; P = .01), and overall 30-day postoperative complications (PCD: 29.8% vs ECD: 15%; P = .03). After matching, a statistically significant difference was retained in ileostomy rates ( P = .02) and 30-day readmissions ( P = .01). Conclusions Early operative intervention after percutaneous drainage in perforating CD may be associated with a high incidence of diversions and readmissions.
- Subjects :
- Adult
Male
medicine.medical_specialty
Abdominal Abscess
Percutaneous
medicine.medical_treatment
Patient Readmission
Cohort Studies
03 medical and health sciences
Ileostomy
0302 clinical medicine
Ileocolectomy
Crohn Disease
Ileum
Humans
Medicine
Propensity Score
Abscess
Glucocorticoids
Colectomy
Retrospective Studies
Crohn's disease
Univariate analysis
business.industry
Incidence (epidemiology)
General Medicine
medicine.disease
Anti-Bacterial Agents
Surgery
Intestinal Perforation
030220 oncology & carcinogenesis
Propensity score matching
Drainage
Female
Parenteral Nutrition, Total
030211 gastroenterology & hepatology
business
Subjects
Details
- ISSN :
- 00029610
- Volume :
- 212
- Database :
- OpenAIRE
- Journal :
- The American Journal of Surgery
- Accession number :
- edsair.doi.dedup.....bebbd8fa11e7b402505f1bbac99c5fc7