P380 Risk factors for poor postoperative outcome in patients with Crohn’s disease undergoing ileocaecal resection

Abstract

Background: The postoperative outcome of intestinal resection in Crohn's disease (CD) patients may be affected by multiple perioperative factors. The objective of this study was to identify risk factors of 30-day postoperative complications in CD disease patients who underwent ileocecal resection. Methods: An observational retrospective monocentric study including CD patients who underwent ileocaecal resection between January 1, 2008 and September 30, 2017 was conducted. Epidemiologic, clinical, biologic, and therapeutic characteristics were abstracted from medical records. Results: We have colliged 89 patients of mean age of 32.8 years old. Indications for ileocecal resection was stricturing disease (n = 52; 57, 8%) and penetrating complications (n = 38 ; 42, 2%). Preoperative medical therapy included steroids (n = 14; 15.6%), immunosuppressants (n = 13; 14.4%), and biologics (n = 4; 4.4%). Laparoscopic ileocecal resection was performed in 55 (61, 1%) patients, while 34 (37, 8%) patients underwent an open ileocecal resection. Postoperative complications have been observed in 7 patients (7, 8%) after a median period of 11.7 days (5-21). The rates of intra-abdominal abscess, anastomotic leak and enteric fistula were 4.4%, 1.1% and 2.2%, respectively. Postoperative complications were associated with no preoperative blood transfusions (p = 0.016) and a low preoperative cholesterol level (<1g/l) (p = 0.016). Intra-abdominal abscess discovered during surgery (p = 0.018) and laparotomic surgery (p = 0.03) were correlated with longer postoperative stay in hospital. Other potential risk factors, such as age, gender, low preoperative haemoglobin or albumin levels, and the use of steroids or biologicals were not associated with the occurrence of postoperative complications in our patients. Conclusions: In CD patients undergoing ileocecal resection, no blood transfusion and low preoperative cholesterol level were associated with unfavourable postoperative outcome. Intra-abdominal abscess discovered during surgery and laparotomy were correlated with longer postoperative stay in hospital.