Our Summary

This research study aimed to see if Crohn’s disease patients who had inflammation at the edges of the area cut out during surgery were more likely to have complications at the point where the intestine is reconnected. The study also looked at other factors that could potentially increase the risk of complications after surgery.

To do this, the researchers studied tissue samples from 70 patients who had surgery due to Crohn’s disease. They checked for inflammation and how severe it was. They also recorded any complications that occurred within a month after surgery. They looked at factors like the patient’s age, whether they had surgery before, their preoperative levels of certain proteins and other biomarkers, their overall health status, whether they were taking medications to suppress the immune system, the surgical method used, and whether there was a fistula or abscess present during surgery.

They found that about two-thirds of the patients had active inflammation at the edges of the cut area - with varying severity. About a fifth of the patients had postoperative complications, but only a small percentage were complications at the reconnection point. They found that the presence of inflammation did not significantly affect the occurrence of complications. Similarly, none of the other factors they examined seemed to significantly increase the risk of complications.

In conclusion, the researchers found that while inflammation at the edges of the cut area is common in Crohn’s disease patients who undergo surgery, the rate of complications after surgery remains low. Therefore, the current practice of removing only the most affected parts of the intestine seems to be a safe choice. However, more research is needed to better understand the risk factors for complications after surgery in Crohn’s disease patients.

FAQs

  1. Does the presence of histologically inflamed resection margins increase postoperative anastomotic complications in Crohn’s disease patients?
  2. What other risk factors for postoperative complications were examined in the study?
  3. Is the current practice of resection of only the most affected bowel segments for Crohn’s disease a safe choice?

Doctor’s Tip

A helpful tip a doctor might tell a patient about bowel resection is to follow a healthy diet and stay hydrated to promote proper healing and reduce the risk of complications. It is also important to follow the postoperative care instructions provided by your healthcare team and attend all follow-up appointments to monitor your recovery. If you experience any concerning symptoms, such as severe abdominal pain, fever, or prolonged diarrhea, contact your healthcare provider immediately.

Suitable For

Patients with Crohn’s disease who are undergoing surgery for bowel resection are typically recommended for the procedure. Other patients who may be recommended for bowel resection include those with bowel obstruction, colon cancer, diverticulitis, or other conditions that affect the intestines.

Timeline

Before bowel resection:

  • Patient is diagnosed with Crohn’s disease and undergoes medical management to control symptoms
  • Patient experiences symptoms such as abdominal pain, diarrhea, weight loss, and fatigue
  • Patient undergoes imaging tests to assess disease extent and severity
  • Patient and healthcare team discuss surgical options and risks
  • Patient prepares for surgery with preoperative testing and consultations

After bowel resection:

  • Patient undergoes surgery to remove affected bowel segments
  • Pathology report shows presence of histologically inflamed resection margins
  • Patient is monitored for postoperative complications, such as anastomotic leaks or infections
  • Patient is discharged from the hospital and starts postoperative recovery and follow-up care
  • Patient may require additional treatments or medications to manage Crohn’s disease symptoms
  • Long-term follow-up is needed to monitor disease activity and potential recurrence.

What to Ask Your Doctor

  1. How common is it to have active inflammation in the bowel resection margin after surgery for Crohn’s disease?
  2. Do patients with active inflammation in the resection margin have a higher risk of postoperative complications, especially anastomotic complications?
  3. What are the other risk factors for postoperative complications in Crohn’s disease patients undergoing bowel resection?
  4. What is the typical follow-up protocol for patients after bowel resection surgery for Crohn’s disease?
  5. Are there any specific measures or precautions that can be taken to reduce the risk of postoperative complications in Crohn’s disease patients undergoing bowel resection?
  6. Should patients with histologically inflamed resection margins be monitored more closely after surgery for any signs of complications?
  7. Are there any specific dietary or lifestyle recommendations for patients after bowel resection surgery for Crohn’s disease to promote healing and reduce the risk of complications?

Reference

Authors: Aaltonen G, Ristimäki A, Keränen I, Carpelan-Holmström M, Lepistö A. Journal: Scand J Gastroenterol. 2018 Mar;53(3):279-283. doi: 10.1080/00365521.2018.1435717. Epub 2018 Feb 12. PMID: 29431516