Postoperative complications in patients with Behçet's disease.

Objective: To assess the proportion of postoperative complications of various surgeries in patients with Behçet's disease (BD) and compare the risk of surgical complications between BD patients and controls.

Methods: We analyzed 389 BD patients who underwent surgeries at Seoul National University Hospital between January 2003 and December 2019. Controls were 1:1 matched with BD patients based on age at surgery, sex, and type of surgery. Generalized estimating equation analyses were performed to compare the postoperative complications between BD patients and controls.

Results: Among 632 surgeries in BD patients, 36 (5.7%) surgical site complications, including wound dehiscence (38.9%), bleeding (13.9%), infections (8.3%), anastomotic dehiscence (22.2%), and stricture (5.6%), occurred after median 12 days (IQR 7.8-22.0). Surgical site complications developed frequently after cardiac (33.3%) and vascular (22.2%) surgeries and rarely occurred after ophthalmic (1.5%) surgeries. Seventeen (2.7%) cases required reoperation within median 15 days (IQR 7.0-43.0). Four patients died within median 21 days (IQR 8.3-41.3 days). After adjustment for confounders, BD patients exhibited a significantly higher risk of surgical site complications (OR 3.4, 95% CI 1.4-8.0) and reoperation (OR 5.2, 95% CI 1.2-22.8) after cardiovascular surgery than controls. However, the risks of surgical site complications and reoperation after other types of surgery were similar in both groups.

Conclusions: The risk of postoperative complications varies according to the type of surgeries among BD patients. While cardiovascular surgeries result in higher perioperative complications in BD patients, ophthalmic surgeries show a safety profile similar to those in non-BD patients. Key Points • Patients with Behçet's disease exhibited an increased risk of surgical site complications and subsequent reoperations after cardiovascular surgery than controls. • The safety profile of ophthalmic surgery was comparable between patients with Behçet's disease and controls. • In patients with Behçet's disease, the risk of postoperative complications varies according to the type of surgery.