Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

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

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Postoperative complications: an observational study of trends in the United States from 2012 to 2018

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Morbidity and mortality after liver surgery for colorectal liver metastases: a cohort study in a high-volume fast-track programme

    Research output: Contribution to journalJournal articleResearchpeer-review

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

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Long-term oncological outcomes in patients undergoing laparoscopic versus open surgery for colon cancer: A nationwide cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Physical activity after colorectal cancer surgery-a cross sectional study of patients with a long-term stoma

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Impact of a Parastomal Bulge on Quality of Life - A Cross-sectional Study of Patients From the Danish Stoma Database

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Antibiotic prescribing in Danish general practice in the elderly population from 2010 to 2017

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

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 .

Original languageEnglish
JournalBMC Surgery
Volume18
Issue number91
ISSN1471-2482
DOIs
Publication statusPublished - 3 Nov 2018

ID: 55573820