RISK FACTORS FOR EARLY POSTOPERATIVE COMPLICATIONS IN ACUTE ESFAGOGÁSTRICE ESPLENECTOMIA INFL COLITIS IN THE ERA OF BIOLOGIC THERAPY

Página do item simplificado
dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorSOBRADO, Lucas Faraco
dc.contributor.authorMORI, Fernando Noboru Cabral
dc.contributor.authorFACANALI, Carolina Bortolozzo Graciolli
dc.contributor.authorCAMARGO, Mariane Gouvea Monteiro
dc.contributor.authorNAHAS, Sergio Carlos
dc.contributor.authorSOBRADO, Carlos Walter
dc.date.accessioned2023-12-15T18:51:47Z
dc.date.available2023-12-15T18:51:47Z
dc.date.issued2023
dc.description.abstractBackground: Despite major advances in the clinical treatment of inflammatory bowel disease, some patients still present with acute colitis and require emergency surgery. Aims: To evaluate the risk factors for early postoperative complications in patients undergoing surgery for acute colitis in the era of biologic therapy. Methods: Patients with inflammatory bowel disease admitted for acute colitis who underwent total colectomy at a single tertiary hospital from 2012 to 2022 were evaluated. Postoperative complications were graded according to Clavien-Dindo classification (CDC). Patients with more severe complications (CDC >= 2) were compared with those with less severe complications (CDC<2). Results: A total of 46 patients underwent surgery. The indications were: failure of clinical treatment (n=34), patients' or surgeon's preference (n=5), hemorrhage (n=3), toxic megacolon (n=2), and bowel perforation (n=2). There were eight reoperations, 60.9% of postoperative complications classified as CDC >= 2, and three deaths. In univariate analyses, preoperative antibiotics use, ulcerative colitis diagnosis, lower albumin levels at admission, and preoperative hospital stay longer than seven days were associated with more severe postoperative complications. Conclusions: Emergency surgery for acute colitis was associated with a high incidence of postoperative complications. Preoperative use of antibiotics, ulcerative colitis, lower albumin levels at admission, and delaying surgery for more than seven days were associated with more severe early postoperative complications. The use of biologics was not associated with worse outcomes.eng
dc.description.abstractRACIONAL: Apesar dos enormes avanços no tratamento das doenças inflamatórias intestinais (DII), alguns pacientes apresentam quadros de colite aguda refratária ao tratamento clínico, e necessitam de cirurgia de urgência. OBJETIVOS: Avaliar os fatores de risco associados com complicações pós-operatórias precoces nos pacientes com colite aguda submetidos a colectomia na era das terapias biológicas. MÉTODOS: Pacientes com DII admitidos com colite aguda grave submetidos a colectomia total em hospital terciário no período de 2012 a 2022 foram analisados. As complicações pós-operatórias foram graduadas de acordo com a classificação Clavien-Dindo (CCD). Pacientes com complicações mais graves (CCD≥2) foram comparados com os menos graves (CCD<2). RESULTADOS: Foram submetidos a cirurgia 46 pacientes. As indicações foram: falha do tratamento conservador (n=34), preferência do paciente ou do cirurgião (n=5), hemorragia (n=3), megacólon tóxico (n=2) e perfuração intestinal (n=2). Reoperação foi necessária em oito pacientes, 60,9% tiveram complicações classificadas como CCD≥2, e três pacientes foram a óbito. Análise univariada identificou que uso de antibióticos no pré-operatório, diagnóstico de colite ulcerativa, hipoalbuminemia na admissão e período de internação maior que sete dias foi associada à complicações pós-operatória mais graves. CONCLUSÕES: Pacientes com colite aguda submetidos a cirurgia de urgência apresentaram alta taxa de complicações pós-operatórias. Uso pré-operatório de antibióticos, diagnóstico de retocolite ulcerativa, hipoalbuminemia na admissão e retardo na operação por mais que sete dias, esteve associado a complicações pós-operatórias mais graves. Uso de biológicos não se associou a piores desfechos.
dc.description.indexMEDLINE
dc.description.indexPubMed
dc.description.indexWoS
dc.description.indexScopus
dc.identifier.citationABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA-BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY, v.36, article ID e1770, 6p, 2023
dc.identifier.doi10.1590/0102-672020230052e1770
dc.identifier.eissn2317-6326
dc.identifier.issn0102-6720
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/57416
dc.language.isoeng
dc.publisherCOLEGIO BRASILEIRO CIRURGIA DIGESTIVA-CBCDeng
dc.relation.ispartofAbcd-Arquivos Brasileiros de Cirurgia Digestiva-brazilian Archives of Digestive Surgery
dc.rightsopenAccesseng
dc.rights.holderCopyright COLEGIO BRASILEIRO CIRURGIA DIGESTIVA-CBCDeng
dc.subjectProctocolitiseng
dc.subjectPostoperative complicationseng
dc.subjectColitiseng
dc.subjectColectomyeng
dc.subjectRisk factorseng
dc.subjectBiological therapyeng
dc.subjectProctocolite
dc.subjectComplicações pós-operatórias
dc.subjectColite
dc.subjectColectomia
dc.subjectFatores de risco
dc.subjectTerapia biológica
dc.subject.othersevere ulcerative-colitiseng
dc.subject.otherrescue therapyeng
dc.subject.othercolectomyeng
dc.subject.otherinfliximabeng
dc.subject.othermanagementeng
dc.subject.otheroutcomeseng
dc.subject.wosGastroenterology & Hepatologyeng
dc.titleRISK FACTORS FOR EARLY POSTOPERATIVE COMPLICATIONS IN ACUTE ESFAGOGÁSTRICE ESPLENECTOMIA INFL COLITIS IN THE ERA OF BIOLOGIC THERAPYeng
dc.title.alternativeFATORES DE RISCO PARA COMPLICAÇÕES PÓS-OPERATÓRIAS PRECOCES EM COLITE AGUDA NA ERA DA TERAPIA BIOLÓGICA
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.citation.scopus1
hcfmusp.contributor.author-fmusphcLUCAS FARACO SOBRADO
hcfmusp.contributor.author-fmusphcFERNANDO NOBORU CABRAL MORI
hcfmusp.contributor.author-fmusphcCAROLINA BORTOLOZZO GRACIOLLI FACANALI
hcfmusp.contributor.author-fmusphcMARIANE GOUVEA MONTEIRO DE CAMARGO
hcfmusp.contributor.author-fmusphcSERGIO CARLOS NAHAS
hcfmusp.contributor.author-fmusphcCARLOS WALTER SOBRADO JUNIOR
hcfmusp.description.articlenumbere1770
hcfmusp.description.volume36
hcfmusp.origemWOS
hcfmusp.origem.pubmed37878974
hcfmusp.origem.scopus2-s2.0-85175219873
hcfmusp.origem.wosWOS:001091690800001
hcfmusp.publisher.citySAO PAULO SPeng
hcfmusp.publisher.countryBRAZILeng
hcfmusp.relation.referenceActis GC, 2007, BMC GASTROENTEROL, V7, DOI 10.1186/1471-230X-7-13eng
hcfmusp.relation.referenceAratari A, 2008, DIGEST LIVER DIS, V40, P821, DOI 10.1016/j.dld.2008.03.014eng
hcfmusp.relation.referenceBartels SAL, 2013, COLORECTAL DIS, V15, P1392, DOI 10.1111/codi.12328eng
hcfmusp.relation.referenceBiondi A, 2012, WORLD J GASTROENTERO, V18, P1861, DOI 10.3748/wjg.v18.i16.1861eng
hcfmusp.relation.referenceCHAPMAN RW, 1986, GUT, V27, P1210, DOI 10.1136/gut.27.10.1210eng
hcfmusp.relation.referenceCoakley BA, 2013, SURGERY, V153, P242, DOI 10.1016/j.surg.2012.08.002eng
hcfmusp.relation.referencede Silva S, 2011, CLIN GASTROENTEROL H, V9, P972, DOI 10.1016/j.cgh.2011.07.016eng
hcfmusp.relation.referenceDindo D, 2004, ANN SURG, V240, P205, DOI 10.1097/01.sla.0000133083.54934.aeeng
hcfmusp.relation.referenceHarbord M, 2017, J CROHNS COLITIS, V11, P769, DOI 10.1093/ecco-jcc/jjx009eng
hcfmusp.relation.referenceHolubar SD, 2021, DIS COLON RECTUM, V64, P783, DOI 10.1097/DCR.0000000000002037eng
hcfmusp.relation.referenceHURST RD, 1995, SURGERY, V118, P748, DOI 10.1016/S0039-6060(05)80045-5eng
hcfmusp.relation.referenceJärnerot G, 2005, GASTROENTEROLOGY, V128, P1805, DOI 10.1053/j.gastro.2005.03.003eng
hcfmusp.relation.referenceKhoudari G, 2022, CLIN GASTROENTEROL H, V20, pE974, DOI 10.1016/j.cgh.2020.10.008eng
hcfmusp.relation.referenceKokkinidis DG, 2017, SCAND J GASTROENTERO, V52, P923, DOI 10.1080/00365521.2017.1326163eng
hcfmusp.relation.referenceLeeds IL, 2017, J GASTROINTEST SURG, V21, P1675, DOI 10.1007/s11605-017-3538-3eng
hcfmusp.relation.referenceLi Y, 2015, J GASTROINTEST SURG, V19, P1842, DOI 10.1007/s11605-015-2893-1eng
hcfmusp.relation.referenceMendonça CM, 2022, ABCD-ARQ BRAS CIR DI, V35, DOI 10.1590/0102-672020210002e1653eng
hcfmusp.relation.referenceNarula N, 2015, INFLAMM BOWEL DIS, V21, P1683, DOI 10.1097/MIB.0000000000000350eng
hcfmusp.relation.referenceNelson R, 2014, INFLAMM BOWEL DIS, V20, P14, DOI 10.1097/01.MIB.0000437497.07181.05eng
hcfmusp.relation.referencePowar MP, 2013, COLORECTAL DIS, V15, P374, DOI 10.1111/j.1463-1318.2012.03188.xeng
hcfmusp.relation.referenceRandall J, 2010, BRIT J SURG, V97, P404, DOI 10.1002/bjs.6874eng
hcfmusp.relation.referenceRibiere S, 2018, PRESSE MED, V47, P312, DOI 10.1016/j.lpm.2018.02.020eng
hcfmusp.relation.referenceSaha SK, 2018, INT J COLORECTAL DIS, V33, P79, DOI 10.1007/s00384-017-2903-8eng
hcfmusp.relation.referenceSobrado CW, 2016, ABCD-ARQ BRAS CIR DI, V29, P201, DOI 10.1590/0102-6720201600030017eng
hcfmusp.relation.referenceTajra JBM, 2023, ABCD-ARQ BRAS CIR DI, V36, DOI 10.1590/0102-672020230002e1730eng
hcfmusp.relation.referenceTRUELOVE SC, 1955, BRIT MED J, V2, P1041, DOI 10.1136/bmj.2.4947.1041eng
hcfmusp.relation.referenceXu YY, 2019, INFLAMM BOWEL DIS, V25, P261, DOI 10.1093/ibd/izy246eng
hcfmusp.scopus.lastupdate2024-05-17
relation.isAuthorOfPublication299c36c2-1118-4151-8a46-7a9b09fa7ca3
relation.isAuthorOfPublicationfbd77eed-33d2-4c59-a871-e6e47d1078a4
relation.isAuthorOfPublication9804c3ec-7554-481f-9eca-73afdaec27a0
relation.isAuthorOfPublication072fb633-a9b0-4a37-886e-8e3620686d5b
relation.isAuthorOfPublication0ab50572-97be-4931-8ade-d2f681c8b19e
relation.isAuthorOfPublication9a1bbab0-4ee3-43da-b488-6a88fbf0e76a
relation.isAuthorOfPublication.latestForDiscovery299c36c2-1118-4151-8a46-7a9b09fa7ca3
Arquivos
Pacote Original
Agora exibindo 1 - 1 de 1
Imagem de Miniatura
Nome:
art_SOBRADO_RISK_FACTORS_FOR_EARLY_POSTOPERATIVE_COMPLICATIONS_IN_ACUTE_2023.PDF
Tamanho:
550.37 KB
Formato:
Adobe Portable Document Format
Descrição:
publishedVersion (English)
Baixar
Coleções
Artigos e Materiais de Revistas Científicas - FM/MGT
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/35