P0480 Evaluating the risk factors of surgery and postoperative complications in stricturing Crohn’s Disease
Authors: Yunusov E , Piyade B , Ergenc I , Tasci M E , Sariyar N , Ozen Alahdab Y , Atug O , Kani H T 
Published: January 2025

Background

Strictures can be developed in approximately half of the Crohn’s disease (CD) patients during the course of the disease. Stricturing CD can be treated by medical, endoscopic and surgical options. In this study, we investigated the risk factors of CD related surgery and postoperative complications in stricturing CD.

Methods

We included the patients with stricturing Crohn’s disease who were followed up in our inflammatory bowel disease specific outpatient clinic between 1989 and 2024. Demographic and clinical data were collected retrospectively from the hospital electronic system and patient files. We divided our cohort into two groups as with and without CD-related surgery, and compared these two groups in terms of factors affecting the need for surgery. We examined the CD-related surgery groupin terms of the development of complications within 90 days following surgery.

Results

A total of 129 patients were included in the study. The mean age was 40.26 ± 14.13 years, and 59 (45.7%) of the patients were female. Sixty-two (48.1%) patients had tobacco exposure or were currently smoking. Nine (7.0%) patients had multiple strictures. Intestinal fistula was present in 35 (68.6%) patients in the surgical group, and it was found to be significantly higher compared to the non-surgical group (p=0.02). While 63 (63.6%) patients in the surgical group had a history of biological use, 36 (36.4%) patients in the non-surgical group had biological exposure, and this difference was statistically significant (p=0.003). Complications developed in 23 (31.5%) of the operated patients in the first 90 days after the operation (19 infectious, 8 non-infectious). Intestinal fistula, multiple stenoses and biological exposure (p = 0.02, p = 0.02, p = &lt; 0.0001, respectively) were observed at a higher rate in the group with complications. In multivariate analysis, biological exposure was found to be a risk factor for surgery (p = 0.01; RR: 3.45), and the presence of abscess was found to be a risk factor for the development of complications following surgery (p = 0.01, RR: 8.09).

Conclusion

In our study, the presence of intestinal fistula and exposure to biological agents were found to be higher in the surgical group. In line with the current literature, the use of biological agents was found to be a factor affecting the need for surgery, and the presence of abscess was found to be a factor affecting postoperative complications (1, 2).

References

1.Bossuyt P, Debeuckelaere C, Ferrante M, de Buck van Overstraeten A, Vanbeckevoort D, Billiet T, Wolthuis A, Cleynen I, Van Assche G, D’Hoore A, Vermeire S. Risk Stratification for Surgery in Stricturing Ileal Crohn’s Disease: The BACARDI Risk Model. J Crohns Colitis. 2018 Jan 5;12(1):32-38.

2.Celentano V, Giglio MC, Pellino G, Rottoli M, Sampietro G, Spinelli A, Selvaggi F; Italian Society of Colorectal Surgery SICCR. High complication rate in Crohn’s disease surgery following percutaneous drainage of intra-abdominal abscess: a multicentre study. Int J Colorectal Dis. 2022 Jun;37(6):1421-1428.