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Digestive Surgery
Article . 2021 . Peer-reviewed
License: CC BY NC
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Digestive Surgery
Article
License: CC BY NC
Data sources: UnpayWall
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Serveur académique lausannois
Article . 2021
License: CC BY NC
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Surgical Resection for Crohn’s and Cancer: A Comparison of Disease-Specific Risk Factors and Outcomes

Authors: David W. Larson; Mohamed A. Abd El Aziz; William Perry; Kevin T. Behm; Sherief Shawki; Jay Mandrekar; Kellie L. Mathis; +1 Authors

Surgical Resection for Crohn’s and Cancer: A Comparison of Disease-Specific Risk Factors and Outcomes

Abstract

<b><i>Background and Objectives:</i></b> The goal of this study was to compare disease-specific risk factors and 30-day outcomes between patients with Crohn’s disease (CD) and colon cancer (CC) undergoing right-sided surgical resection. <b><i>Methods:</i></b> The American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP<sup>®</sup>) was interrogated to extract all patients ≥18 years undergoing elective right-sided resection for CD versus CC. Independent risk factors for surgical complications were identified through multivariable logistic regression for both groups. In a second step, surgical and medical 30-day morbidity was compared after risk adjustment. <b><i>Results:</i></b> The cohort consisted of 17,516 patients, of which 2,899 (16.6%) underwent surgery for CD versus 14,617 (83.4%) for CC. Independent risk factors for surgical complications in patients with CD were male gender, African American race, ASA score (III or IV), active smoking, prolonged surgery, and preoperative anemia. Independent risk factors for surgical complications in the cancer group were age ≥70 years, male gender, ASA score (III or IV), respiratory and cardiovascular comorbidities, and preoperative hypoalbuminemia (&#x3c;3.5 g/dL). After risk adjustment, surgical complications (OR 1.25, <i>p</i> = 0.002), sepsis (OR 1.64, <i>p</i> = 0.012), and unplanned readmissions (OR 1.39, <i>p</i> = 0.004) were more common in patients with CD. Thirty-day mortality was higher in cancer patients (1.1 vs. 0.1%, <i>p</i> &#x3c; 0.0001). <b><i>Conclusions:</i></b> Patients with Crohn’s disease were more prone to surgical complications and postoperative sepsis compared to the cancer group undergoing the same procedure. Careful evaluation and correction of disease-specific modifiable risk factors of patients with CD and CC, respectively, are important.

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Keywords

Male, Operative Time, Smoking, Comorbidity, Middle Aged, Patient Readmission, Postoperative Complications, Sex Factors, Crohn Disease, Risk Factors, Colonic Neoplasms, Aged; Colonic Neoplasms/surgery; Comorbidity; Crohn Disease/surgery; Female; Humans; Male; Middle Aged; Operative Time; Patient Readmission/statistics & numerical data; Postoperative Complications/epidemiology; Risk Factors; Sex Factors; Smoking/adverse effects; Switzerland/epidemiology; Colon cancer; Crohn’s disease; Morbidity; Right colectomy, Humans, Female, Switzerland, Aged

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    selected citations
    These citations are derived from selected sources.
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    16
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Average
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
16
Top 10%
Average
Top 10%
Green
hybrid
Related to Research communities
Cancer Research