Watchful waiting after radiological guided drainage of intra-abdominal abscess in patients with Crohn's Disease might be associated with increased rates of stoma construction

Background: Management of spontaneous intra-abdominal abscess (IAA) in patients with Crohn's disease (CD) with radiologically guided percutaneous drainage (PD) was debated. Methods: This is a secondary analysis from a multicenter, retrospective cohort study of all the patients with CD who u...

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Autores: El-Hussuna, Alaa, Alonso, Sandra, Pera Román, Miguel, Qvist, Niels
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/59415
Acceso en línea:http://hdl.handle.net/10230/59415
http://dx.doi.org/10.1093/crocol/otad038
Access Level:acceso abierto
Palabra clave:Crohn’s disease
Abscess
Complications
Stoma
Surgery
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spelling Watchful waiting after radiological guided drainage of intra-abdominal abscess in patients with Crohn's Disease might be associated with increased rates of stoma constructionEl-Hussuna, AlaaAlonso, SandraPera Román, MiguelQvist, NielsCrohn’s diseaseAbscessComplicationsStomaSurgeryBackground: Management of spontaneous intra-abdominal abscess (IAA) in patients with Crohn's disease (CD) with radiologically guided percutaneous drainage (PD) was debated. Methods: This is a secondary analysis from a multicenter, retrospective cohort study of all the patients with CD who underwent PD followed by surgery at 19 international tertiary centers. Results: Seventeen patients (4.8%) who did not undergo surgery after PD were compared to those who had PD followed by surgical intervention 335/352 (95.2%). Patients who had PD without surgery were those with longer disease duration, more frequently had previous surgery for CD (laparotomies/laparoscopies), enteric fistula, on steroid treatment before and continue to have it after PD. Patients who had PD without subsequent surgical resection had a higher risk of stoma construction at later stages 8/17 (47.1%) versus 90/326 (27.6%) (P < .01). Patients with PD with no subsequent surgery had numerically higher rates of abscess recurrence 5/17 (29.4%) compared to those who had PD followed by surgery 45/335 (13.4%) the difference was not statistically significant (P = .07). Conclusions: Even with the low number of patients enrolled in this study who had PD of IAA without subsequent surgery, the findings indicate a markedly worse prognosis in terms of recurrence, length of stay, readmission, and stoma construction. Watchful waiting after PD to treat patients with spontaneous IAA might be indicated in selected patients with poor health status or poor prognostic factors.Oxford University Press202420242023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/59415http://dx.doi.org/10.1093/crocol/otad038reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésCrohns Colitis 360. 2023 Jul 19;5(3):otad038© The Author(s) 2023. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.comhttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/594152026-06-12T07:21:37Z
dc.title.none.fl_str_mv Watchful waiting after radiological guided drainage of intra-abdominal abscess in patients with Crohn's Disease might be associated with increased rates of stoma construction
title Watchful waiting after radiological guided drainage of intra-abdominal abscess in patients with Crohn's Disease might be associated with increased rates of stoma construction
spellingShingle Watchful waiting after radiological guided drainage of intra-abdominal abscess in patients with Crohn's Disease might be associated with increased rates of stoma construction
El-Hussuna, Alaa
Crohn’s disease
Abscess
Complications
Stoma
Surgery
title_short Watchful waiting after radiological guided drainage of intra-abdominal abscess in patients with Crohn's Disease might be associated with increased rates of stoma construction
title_full Watchful waiting after radiological guided drainage of intra-abdominal abscess in patients with Crohn's Disease might be associated with increased rates of stoma construction
title_fullStr Watchful waiting after radiological guided drainage of intra-abdominal abscess in patients with Crohn's Disease might be associated with increased rates of stoma construction
title_full_unstemmed Watchful waiting after radiological guided drainage of intra-abdominal abscess in patients with Crohn's Disease might be associated with increased rates of stoma construction
title_sort Watchful waiting after radiological guided drainage of intra-abdominal abscess in patients with Crohn's Disease might be associated with increased rates of stoma construction
dc.creator.none.fl_str_mv El-Hussuna, Alaa
Alonso, Sandra
Pera Román, Miguel
Qvist, Niels
author El-Hussuna, Alaa
author_facet El-Hussuna, Alaa
Alonso, Sandra
Pera Román, Miguel
Qvist, Niels
author_role author
author2 Alonso, Sandra
Pera Román, Miguel
Qvist, Niels
author2_role author
author
author
dc.subject.none.fl_str_mv Crohn’s disease
Abscess
Complications
Stoma
Surgery
topic Crohn’s disease
Abscess
Complications
Stoma
Surgery
description Background: Management of spontaneous intra-abdominal abscess (IAA) in patients with Crohn's disease (CD) with radiologically guided percutaneous drainage (PD) was debated. Methods: This is a secondary analysis from a multicenter, retrospective cohort study of all the patients with CD who underwent PD followed by surgery at 19 international tertiary centers. Results: Seventeen patients (4.8%) who did not undergo surgery after PD were compared to those who had PD followed by surgical intervention 335/352 (95.2%). Patients who had PD without surgery were those with longer disease duration, more frequently had previous surgery for CD (laparotomies/laparoscopies), enteric fistula, on steroid treatment before and continue to have it after PD. Patients who had PD without subsequent surgical resection had a higher risk of stoma construction at later stages 8/17 (47.1%) versus 90/326 (27.6%) (P < .01). Patients with PD with no subsequent surgery had numerically higher rates of abscess recurrence 5/17 (29.4%) compared to those who had PD followed by surgery 45/335 (13.4%) the difference was not statistically significant (P = .07). Conclusions: Even with the low number of patients enrolled in this study who had PD of IAA without subsequent surgery, the findings indicate a markedly worse prognosis in terms of recurrence, length of stay, readmission, and stoma construction. Watchful waiting after PD to treat patients with spontaneous IAA might be indicated in selected patients with poor health status or poor prognostic factors.
publishDate 2023
dc.date.none.fl_str_mv 2023
2024
2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/59415
http://dx.doi.org/10.1093/crocol/otad038
url http://hdl.handle.net/10230/59415
http://dx.doi.org/10.1093/crocol/otad038
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Crohns Colitis 360. 2023 Jul 19;5(3):otad038
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Oxford University Press
publisher.none.fl_str_mv Oxford University Press
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
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