Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

No effect of anti-TNF-α agents on the surgical stress response in patients with inflammatory bowel disease undergoing bowel resections: a prospective multi-center pilot study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Open ventral hernia repair with a composite ventral patch - final results of a multicenter prospective study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Patient experiences with interventions to reduce surgery cancellations: a qualitative study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Will emergency and surgical patients participate in and complete alcohol interventions? A systematic review

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. ECCO Guidelines on Therapeutics in Crohn's Disease: Surgical Treatment

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Associations between blood cultures after surgery for colorectal cancer and long-term oncological outcomes

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. The clinical implication of the association between hypoxaemia and postoperative troponin I: a reply

    Publikation: Bidrag til tidsskriftKommentar/debatForskningpeer review

Vis graf over relationer

BACKGROUND: TNF-α plays a role in angiogenesis and collagen synthesis, both essential in the wound healing process. There are concerns that pre-operative anti-TNF-α treatment may influence the surgical stress response and increase the risk of surgical complications. The aim of this study was to describe the surgical stress response in patients with inflammatory bowel disease (IBD) and to investigate whether the pre-operative administration of anti-tumor necrosis factor alpha (anti-TNF-α) agents modify the surgical stress response.

METHODS: This was a prospective, multi-center cohort pilot study. The primary outcome was the change in concentration of immunological biomarkers of the surgical stress response (TNF-α, IL-6, and IL-10). Secondary outcome measures were changes in IL-8, IL-17A, C-reactive protein, white blood cells, cortisol, transferrin, ferritin, and D-Dimer in addition to 30 days' post-operative complications and length of post-operative stay in the hospital (LOS).

RESULTS: Forty-six patients with IBD undergoing major abdominal surgery were included, and 18 received anti-TNF- α treatment pre-operatively. Peak increase of most of the immunological biomarkers occurred 6 hours after surgical incision. Then the concentration decreased after 24 h followed by a plateau at 48 h. After adjusting for confounders including detectable blood concentrations, no difference in the concentrations of immunological, endocrinological or haematological biomarkers of stress was found between anti-TNF-α treated and anti-TNF-α naïve patients. No increase in post-operative complications or LOS was noticed in patients who received anti-TNF-α treatment.

CONCLUSIONS: Anti-TNF-α did not affect surgical stress response in this pilot study. Withdrawal of anti-TNF-α drugs prior to surgical intervention in IBD patients might not be justified without measurement of drug concentration and drug antibodies.

TRIAL REGISTRATION: Clinicaltrails.gov.: NCT01974869 .

OriginalsprogEngelsk
TidsskriftBMC Surgery
Vol/bind18
Udgave nummer91
ISSN1471-2482
DOI
StatusUdgivet - 3 nov. 2018

ID: 55573820