S. Groene1, C. Chandrasekera1, T. Prasad1, A. Lincourt1, B. T. Heniford1, V. Augenstein1 1Carolinas Medical Center,Division Of Gastrointestinal And Minimally Invasive Surgery,Charlotte, NC, USA
Introduction: Given the pathophysiology of Crohns disease as well as the fact that patients undergoing surgery are often immunosuppressed, it is often felt that there are more adverse outcomes for patients with Crohns disease who undergo colorectal resections compared to those without the disease. The aim of this study was to compare outcomes of patients with and without Crohns disease following colorectal resections.
Methods: Review of the Carolinas Medical Center (CMC) NSQIP data for colorectal procedures performed from 2013 to 2015 was conducted. Patients were classified as having Crohns disease (CD) based upon ICD-9 codes (555.9, 555.2, 555.1). Demographics, pre-operative co-morbidities, minor and major complications were evaluated using standard statistical methods.
Results: There were 637 patients in the sample; 23 patients with the diagnosis of CD and 614 without CD. Mean age was 37.3±15.2 vs 61.2±13.4 (p<0.001) and the mean BMI was 23±6.2 vs 28.6±7.6 (p<0.001) for those with and without CD, respectfully. Those with CD were more likely to have a pre-operative weight loss of ≥10 pounds (17.4% vs 4.3%; p=0.02) and use pre-operative steroids (56.5% vs 5.9%; p<0.001). Those without CD had a higher rate of pre-operative hypertension (54.4% vs 8.7%; p<0.001). Post-operatively, patients with CD had a higher rate of wound disruptions (8.7% vs 0.7%; p=0.02). There were no significant differences in post-operative surgical site infections, pneumonia, UTIs, sepsis, anastomotic leaks, unplanned returns to the OR, cardiac or renal disease, length of stay and 30 day mortality between those with and without CD.
Conclusion: Patients with Crohns disease tended to be younger and leaner than those who underwent surgery without the disease. Furthermore, they had more pre-operative weight loss and used steroids. Although patients with CD had more post-operative wound disruptions, colorectal resections can be undertaken without otherwise-significantly increased risks.