Morbid obesity among Crohn's disease patients is on the rise and is associated with a higher rate of surgical complications after ileocolic resection

IF 2.9 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Colorectal Disease Pub Date : 2025-01-10 DOI:10.1111/codi.17286

Yaron Rudnicki, Giacomo Calini, Solafah Abdalla, Dorin Colibaseanu, David W. Larson, Kellie L. Mathis

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Abstract

Aim

Crohn's disease (CD) is regarded as a wasting disease, yet there is a growing population of CD patients with a body mass index (BMI) of 35 and above. The rate of postoperative complications is relatively high in CD patients but might be even higher in CD with morbid obesity (MO).

Methods

This was a retrospective study using a prospectively maintained database of all patients undergoing Ileocolic resection for CD between 2014 and 2021 in two referral centres, comparing postoperative complication rates according to BMI.

Results

Three hundred and forty-six patients were identified. Sixty patients (17%) had a BMI over 30 kg/m², and 28 (8.1%) had a BMI of over 35 kg/m² (>35 group). The BMI >35 group had more women (78.6% vs. 52%, P < 0.1), a higher rate of patients not receiving an anastomosis (7.1% vs. 2.5%, P = 0.02), a higher rate of any postoperative surgical complication (32.1% vs. 25.2%, P = 0.4), with a higher rate of Clavien–Dindo ≥3 (14.3% vs. 7.2%, P = 0.25), a higher rate of stoma creation on reoperation for complications (7.2% vs. 1.7%, P = 0.04), a higher rate of 30-day readmission due to intra-abdominal abscess (10.7% vs. 4.7%, P = 0.2), but a lower rate of postoperative medical complications (3.6% vs. 15.7%, P < 0.01).

Conclusions

The rate of MO among CD patients requiring ileocolonic resection is on the rise. MO in this setting is associated with statistically non-significant increases in all surgical complications, severe complications, readmission, and a higher chance for a bailout stoma creation upon reoperation. However, MO seems to be a protective factor for medical postoperative complications, which might suggest better nutritional status.

查看原文本刊更多论文

克罗恩病患者的病态肥胖呈上升趋势，并与回肠结肠切除术后手术并发症的高发率相关。

目的：克罗恩病（CD）被认为是一种消耗性疾病，然而越来越多的患者体重指数（BMI）在35及以上。乳糜泻患者术后并发症的发生率相对较高，而伴有病态肥胖（MO）的乳糜泻患者的并发症发生率可能更高。方法：这是一项回顾性研究，使用了2014年至2021年间在两个转诊中心接受回肠结肠切除术的所有CD患者的前瞻性数据库，根据BMI比较术后并发症发生率。结果：共鉴定出346例患者。60例（17%）患者BMI超过30 kg/m2, 28例（8.1%）患者BMI超过35 kg/m2（>35组）。BMI指数bbb35组有更多的女性（78.6% vs. 52%） P结论：需要回肠结肠切除术的CD患者中MO的发生率正在上升。在这种情况下，MO与所有手术并发症、严重并发症、再入院以及再次手术时救助造口的更高机会的统计学上无显著性增加有关。然而，MO似乎是医疗术后并发症的保护因素，这可能表明更好的营养状况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Colorectal Disease 医学-胃肠肝病学

CiteScore

6.10

自引率

11.80%

发文量

406

审稿时长

1.5 months

期刊介绍： Diseases of the colon and rectum are common and offer a number of exciting challenges. Clinical, diagnostic and basic science research is expanding rapidly. There is increasing demand from purchasers of health care and patients for clinicians to keep abreast of the latest research and developments, and to translate these into routine practice. Technological advances in diagnosis, surgical technique, new pharmaceuticals, molecular genetics and other basic sciences have transformed many aspects of how these diseases are managed. Such progress will accelerate. Colorectal Disease offers a real benefit to subscribers and authors. It is first and foremost a vehicle for publishing original research relating to the demanding, rapidly expanding field of colorectal diseases. Essential for surgeons, pathologists, oncologists, gastroenterologists and health professionals caring for patients with a disease of the lower GI tract, Colorectal Disease furthers education and inter-professional development by including regular review articles and discussions of current controversies. Note that the journal does not usually accept paediatric surgical papers.