Patients with Crohn's disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications' rate

2015 European Society of Coloproctology (ESCP) collaborating group

doi:10.4240/wjgs.v11.i5.261

Patients with Crohn's disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications' rate

World J Gastrointest Surg. 2019 May 27;11(5):261-270. doi: 10.4240/wjgs.v11.i5.261.

Author

2015 European Society of Coloproctology (ESCP) collaborating group

Collaborators

2015 European Society of Coloproctology (ESCP) collaborating group:
S Dich Grandt, A El-Hussuna, M Frasson, B Singh, G Gallo, F Pata, I Negoi, T Pinkney, O Zmora, A Bhangu, N Battersby, S Chaudhri, D Nepogodiev, S Vennix, J Glasbey, A Minaya, L Basso, M Pukuotukai, M E Kelly, L Sánchez Guillén, G Pellino, N Buchs, D Morton, T Pinkney, W Bemelman, P Christensen, A D'Hoore, S Laurberg, M Rubbini, C Vaizey, L Magill, R Perry, N Sheward, R N Mortensen, M Cillo, D Estefania, J Patron Uriburu, H Ruiz, M Salomon, A Makhmudov, L Selnyahina, A Varabei, Y Vizhynis, D Claeys, B Defoort, F Muysoms, P Pletinckx, V Vergucht, I Debergh, T Feryn, H Reusens, D Francart, C Jehaes, S Markiewicz, B Monami, J Weerts, W Bouckaert, B Houben, J Knol, G Sergeant, G Vangertruyden, L Haeck, C Lange, C Sommeling, K Vindevoghel, S Castro, H De Bruyn, M Huyghe, E De Wolf, D Reynders, A D'Hoore, A de Buck van Overstraeten, A Wolthuis, S Delibegovic, A Christiani, M Marchiori Jr, C Rocha de Moraes, V Tercioti Jr, E Arabadjieva, D Bulanov, D Dardanov, V Stoyanov, A Yonkov, K Angelov, S Maslyankov, M Sokolov, G Todorov, S Toshev, Y Georgiev, A Karashmalakov, G Zafirov, X Wang, D Condic, D Kraljik, H Mrkovic, V Pavkovic, K Raguž, V Bencurik, E Holášková, M Skrovina, M Farkašová, T Grolich, Z Kala, F Antos, V Pruchova, O Sotona, M Chobola, T Dusek, A Ferko, J Örhalmi, J Hoch, P Kocian, L Martinek, I Bernstein, K Gotschalck Sunesen, J Leunbach, O Thorlacius-Ussing, A Uth Oveson, P Christensen, S Dahl Chirstensen, V Gamez, M Oeting, U Schou Loeve, A Ugianskis, M Jessen, P M Krarup, K Linde, Q Mirza, J Overgaard Stovring, L Erritzøe, H Loft Jakobsen, J Lykke, E Palmgren Colov, A Husted Madsen, T Linde Friis, J Amstrup Funder, R Dich, S Kjær, S Rasmussen, N Schlesinger, M Dilling Kjaer, N Qvist, A Khalid, G Ali, A El-Hussuna, S Hadi, L Rosell Walker, A Kivelä, T Lehtonen, A Lepistö, T Scheinin, P Siironen, J Kössi, P Kuusanmäki, T Tomminen, A Turunen, T Rautio, M Vierimaa, H Huhtinen, J Karvonen, M Lavonius, A Rantala, P Varpe, E Cotte, Y Francois, O Glehen, V Kepenekian, G Passot, L Maggiori, G Manceau, Y Panis, M Gout, E Rullier, B van Geluwe, N Chafai, J H Lefevre, Y Parc, E Tiret, C Couette, E Duchalais, A Agha, M Hornberger, A Hungbauer, I Iesalnieks, I Weindl, F Crescenti, M Keller, N Kolodziejski, R Scherer, D Sterzing, B Bock, G Boehm, M El-Magd, C Krones, M Niewiera, J Buhr, S Cordesmeyer, M Hoffmann, K Krückemeier, T Vogel, M Schön, J Baral, T Lukoschek, S Münch, F Pullig, K Horisberger, P Kienle, J Magdeburg, S Post, K Batzalexis, S Germanos, C Agalianos, C Dervenis, N Gouvas, P Kanavidis, A Kottikias, I E Katsoulis, D Korkolis, G Plataniotis, G Sakorafas, I Akrida, M Argentou, C Kollatos, C Lampropoulos, S Tsochatzis, I Besznyák, A Bursics, T Egyed, G Papp, I Svastics, J Atladottir, P Möller, H Sigurdsson, T Stefánsson, E Valsdottir, E Andrews, N Foley, D Hechtl, M Majeed, M McCourt, A Hanly, J Hyland, S Martin, P R O'Connell, D Winter, T Connelly, W Joyce, P Wrafter, R Berkovitz, S Avital, I Haj Yahia, N Hermann, B Shpitz, I White, Y Lishtzinsky, A Tsherniak, N Wasserberg, N Horesh, U Keler, R Pery, R Shapiro, O Zmora, H Tulchinsky, B Badran, K Dayan, A Iskhakov, J Lecaros, N Nabih, I Angrima, R Bardini, E Pizzolato, M Tonello, F Arces, R Balestri, C Ceccarelli, V Prosperi, E Rossi, I Giannini, L Vincenti, F Di Candido, M Di Iena, A Guglielmi, O Caputi-Iambrenghi, P Marsanic, A Mellano, A Muratore, M Annecchiarico, L Bencini, S Amore Bonapasta, A Coratti, F Guerra, C R Asteria, L Boccia, L Gerard, A Pascariello, G Manca, F Marino, A Casaril, M Inama, G Moretto, C Bacchelli, M Carvello, N Mariani, M Montorsi, A Spinelli, E Romairone, S Scabini, A Belli, F Bianco, S De Franciscis, G Maria Romano, P Delrio, U Pace, D Rega, C Sassaroli, D Scala, R De Luca, E Ruggieri, C Elbetti, A Garzi, L Romoli, M Scatizzi, A Vannucchi, G Curletti, V Durante, R Galleano, F Mariani, L Reggiani, R Bellomo, A Infantino, L Franceschilli, P Sileri, I Clementi, D Coletta, F La Torre, A Mingoli, F Velluti, A Di Giacomo, A Fiorot, M Massani, L Padoan, C Ruffolo, S Caruso, F Franceschini, R Laessig, I Monaci, M Rontini, P De Nardi, U Elmore, M Lemma, R Rosati, A Tamburini, M De Luca, A Sartori, A Benevento, C Bottini, C C Ferrari, F Pata, G Tessera, G Pellino, F Selvaggi, A Lanzani, F Romano, G Sgroi, F Steccanella, L Turati, T Yamamoto, G Ancans, S Gerkis, M Leja, A Pcolkins, A Sivins, T Latkauskas, P Lizdenis, Ž Saladžinskas, S Švagždys, A Tamelis, A Razbadauskas, M Sokolovas, A Dulskas, N Samalavicius, V Jotautas, S Mikalauskas, E Poskus, T Poskus, K Strupas, C Camenzuli, C Cini, A Predrag, J Psaila, N Spiteri, W Bemelman, C Buskens, E J de Groof, J Gooszen, P Tanis, E Belgers, P Davids, E Furnee, E Postma, A Pronk, N Smakman, S Clermonts, D Zimmerman, J Omloo, E van der Zaag, P van Duijvendijk, E Wassenaar, M Bruijninckx, E de Graff, P Doornebosch, G Tetteroo, M Vermaas, G Iordens, S Knops, B Toorenvliet, H L van Westereenen, E Boerma, P Coene, E van der Harst, A Van Der Pool, M Raber, J Melenhorst, S de Castro, M Gerhards, M Arron, A Bremers, H de Wilt, F Ferenschild, S Yauw, H Cense, A Demirkiran, M Hunfeld, I Mulder, J Nonner, H Swank, B van Wagensveld, M Bolmers, J Briel, A van Geloven, E Echazarreta-Gallego, M Elia-Guedea, J Ramirez, C van Rossem, V Klemann, J Konsten, B Leenders, T Schok, W Bleeker, A Gidwani, R Lawther, P Loughlin, B Skelly, R Spence, M Brun, M Helgeland, D Ignjatovic, T Øresland, P Yousefi, I Flåten Backe, O Helmer Sjo, A Nesbakken, M Tandberg Eriksen, A Cais, J Hallvard Træland, R Herikstad, H Kørner, N Lauvland, D Jajtner, W Kabiesz, M Rak, L Gmerek, K Horbacka, N Horst, P Krokowicz, A Kwiatkowski, K Pasnik, P Karcz, M Romaniszyn, T Rusek, P Walega, R Czarencki, Z Obuszko, M Sitarska, W Wojciech, M Zawadzki, S Amado, P Clara, A Couceiro, R Malaquias, N Rama, A Almeida, E Barbosa, E Cernadas, A Duarte, P Silva, S Costa, C Martinez Insua, J Pereira, C Pereira, M Sacchetti, B Carvalho Pinto, P Jorge Vieira Sousa, R Marques, A Oliveira, R Cardoso, S Carlos, J Corte-Real, P Moniz Pereira, R Souto, C Carneiro, R Marinho, V Nunes, R Rocha, M Sousa, J Leite, F Melo, J Pimentel, L Ventura, C Vila Nova, C Copăescu, V Bintintan, C Ciuce, G Dindelegan, R Scurtu, R Seicean, N Domansky, A Karachun, A Moiseenko, Y Pelipas, A Petrov, I Pravosudov, R Aiupov, Y Akmalov, A Parfenov, N Suleymanov, N Tarasov, H Jumabaev, Z Mamedli, A Rasulov, I Aliev, I Chernikovskiy, V Kochnev, K Komyak, I Pravosudov, A Smirnov, S Achkasov, K Bolikhov, Y Shelygin, O Sushkov, A Zapolskiy, M Gvozdenovic, D Jovanovic, Z Lausevic, D Cvetković, M Maravić, B Milovanovic, N Stojakovic, I Tripković, D Mihajlovic, M Nestorovic, V Pecic, D Petrovic, G Stanojevic, G Barisic, I Dimitrijevic, Z Krivokapic, V Markovic, M Popovic, A Aleksic, D Dabic, I Kostic, A Milojkovic, V Perunicic, D Lukic, T Petrovic, D Radovanovic, Z Radovanovic, V M Cuk, V V Cuk, M Kenic, B Kovacevic, I Krdzic, J Korcek, M Rems, J Toplak, J Escarrâ, M Gil Barrionuevo, T Golda, E Kreisler Moreno, C Zerpa Martin, C Álvarez Laso, P Cumplido, H Padin, J Baixauli Fons, J Hernández Lizoain, P Martinez Ortega, M Molina Fernández, C Sánchez Justicia, J Antonio Gracia Solanas, E Córdoba Díaz de Laspra, E Echazarreta-Gallego, M Elia-Guedea, J Ramirez, J Arredondo Chaves, P Diez González, T Elosua, J Sahagún, A Turienzo Frade, J Álvarez Conde, E Castrillo, R Diaz Maag, V Maderuelo, L Saldarriaga, I Aldrey Cao, X Fernández Varela, S Núñez Fernández, A Parajó Calvo, S Villar Álvarez, I Blesa Sierra, A Duarte, R Lozano, M Márquez, O Porcel, P Menendez, M Fernández Hevia, L Flores Sigüenza, M Jimenez Toscano, A Lacy Fortuny, J Ordoñez, A Espi, S Garcia Botello, J Martín Arévalo, D Moro Valdezate, MartíV Pla, F Blanco Antona, J Abrisqueta, N Ibañez Canovas, J Lujan Mompean, D Escolá Ripoll, S Martinez Gonzalez, J Parodi, A Fernández López, M Ramos Fernández, J Castellvi Valls, L Ortiz de Zarate, R Ribas, D Sabia, L Viso, S Alonso Gonçalves, M José Gil, M Pascual Damieta, M Pera, S Salvans Ruiz, J Bernal, F Landete, G Ais, J Etreros, J Aguiló Lucia, A Boscá, S Deusa, J García Del Caño, V Viciano, J García Armengol, J Roig, J Blas, J Escartin, J Fatás, J Fernando, R Ferrer, R Arias Pacheco, L García Flórez, M Moreno Gijón, J Otero Díez, L Solar Garcia, F Aguilar Teixido, C Balaguer Ojo, J Bargallo Berzosa, S Lamas Moure, J Enrique Sierra, A Fermiñán, F Herrerias, M Rufas, J Viñas, A Codina Cazador, R Farrés, N Gómez, D Julià, P Planellas, J López, A Luna, C Maristany, A Muñoz Duyos, N Puértolas, M Alcantara Moral, X Serra Aracil, P Concheiro Coello, D Gómez, C Carton, A Miguel, F Reoyo Pascual, X Valero Cerrato, R Zambrano Muñoz, J Cervera Aldama, J García González, J Ramos Prada, M Santamaría Olabarrieta, A Urigüen Echeverría, R Coves Alcover, J Espinosa Soria, E Fernandez Rodriguez, J Hernandis Villalba, V Maturana Ibañez, F De la Torre Gonzalez, D Huerga, E Pérez Viejo, A Rivera, E Ruiz Ucar, J Garcia Septiem, V Jiménez, J Jiménez Miramón, J Ramons Rodriquez, V Rodriguez Alvarez, A Garcea, L Ponchietti, N Borda, J Enriquez Navascues, Y Saralegui, G Febles Molina, E Nogues, M Rodríguez, C Roque Castellano, Y Sosa Quesada, M Alvarez Gallego, I Pascual, I Rubio Perez, B Diaz San Andrés, F Tone Villanueva, J Alonso, C Cagigas, J Castillo, M Gómez, J Martín Parra, M Mengual Ballester, E Pellicer Franco, V Soria Aledo, G Valero Navarro, E Caballero Rodríguez, P Gonzalez De Chaves, G Hernandez, A Perez Alvarez, A Soto Sanchez, F Cesar Becerra Garcia, J Guillermo Alonso Roque, Rodríguez López, F Arias, S R Del Valle Ruiz, G Sánchez De La Villa, A Compañ, A García Marín, C Nofuentes, MicóF Orts, V Pérez Auladell, M Carrasco, C Duque Perez, S Gálvez Pastor, I Navarro Garcia, A Sanchez Perez, D Enjuto, F Manuel Bujalance, N Marcelin, M Pérez, R Serrano García, A Cabrera, F de la Portilla, J Diaz Pavon, R Jimenez Rodriguez, J Vazquez Monchul, J Martínez Alegre, I Ortega, A Picardo Nieto Antonio, A Caro, J Escuder, F Feliu, M Millan, R Alos Company, A Frangi Caregnato, R Lozoya Trujillo, R Rodríguez Carrillo, M Ruiz Carmona, N Alonso, D Ambrona Zafra, B Amilka Ayala, C J Bonnin Pascual, C Pineño Flores, J Alcazar Montero, M Angoso Clavijo, J Garcia, J Sanchez Tocino, C Gómez Alcazar, D Costa Navarro, J Ferri Romero, M Rey Riveiro, M Romero Simó, B Arencibia, P Esclapez, M Frasson, E García Granero, P Granero, F J Medina Fernández, A B Gallardo Herrera, C Diaz López, E Navarro Rodriguez, E Torres Tordera, J Arenal, M Citores, J Marcos, J Sánchez, C Tinoco, E Espin, A Garcia Granero, L Jimenez Gomez, J Sanchez Garcia, F Vallribera, J Folkesson, F Sköldberg, K Bergman, E Borgström, J Frey, A Silfverberg, M Söderholm, J Nygren, J Segelman, D Gustafsson, A Lagerqvist, A Papp, M Pelczar, M Abraham Nordling, M Ahlberg, A Sjovall, J Tengstrom, K Hagman, A Chabok, E Ezra, M Nikberg, K Smedh, C Tiselius, N Al Naimi, M Dao Duc, J Meyer, M Mormont, F Ris, G Prevost, P Villiger, H Hoffmann, C Kettelhack, P Kirchhoff, D Oertli, B Weixler, B Aytac, S Leventoglu, B Mentes, O Yuksel, S Demirbas, B Busra Ozkan, G Selçuk Özbalci, U Sungurtekin, B Gülcü, E Ozturk, T Yilmazlar, C Challand, N Fearnhead, R Hubbard, S Kumar, J Arthur, C Barben, P Skaife, S Slawik, M Williams, M Zammit, J Barker, J French, I Sarantitis, C Slawinski, R Clifford, N Eardley, M Johnson, C McFaul, D Vimalachandran, S Allan, A Bell, E Oates, V Shanmugam, A Brigic, M Halls, P Pucher, B Stubbs, T Agarwal, A Chopada, S Mallappa, M Pathmarajah, C Sugden, C Brown, E Macdonald, A Mckay, J Richards, A Robertson, M Kaushal, P Patel, S Tezas, N Touqan, S Ayaani, K Marimuthu, B Piramanayagam, M Vourvachis, N Iqbal, S Korsgen, C Seretis, U Shariff, S Arnold, N Battersby, H Chan, E Clark, R Fernandes, B Moran, A Bajwa, D McArthur, K Cao, P Cunha, H Pardoe, A Quddus, K Theodoropoulou, C Bolln, G Denys, M Gillespie, N Manimaran, J Reidy, A I Malik, A Malik, J Pitt, K Aryal, A El Hadi, R Lal, A Pal, V Velchuru, S Chaudhri, M Oliveira Cunha, B Singh, M Thomas, S Bains, K Boyle, A Miller, M Norwood, J Yeung, L Goian, S Gurjar, W Saghir, N Sengupta, E Stewart Parker, S Bailey, T Khalil, D Lawes, S Nikolaou, G Omar, R Church, B Muthiah, W Garrett, P Marsh, N Obeid, S Chandler, P Coyne, M Evans, L Hunt, J Lim, Z Oliphant, E Papworth, H Weaver, K Cuiñas Leon, G Williams, J Hernon, S Kapur, R Moosvi, I Shaikh, L Swafe, M Aslam, J Evans, U Ihedioha, P Kang, J Merchant, R Hompes, R Middleton, A Broomfield, D Crutten Wood, J Foster, G Nash, M Akhtar, M Boshnaq, S Eldesouky, S Mangam, M Rabie, J Ahmed, J Khan, N Ming Goh, A Shamali, S Stefan, D Nepogodiev, T Pinkney, C Thompson, A Amin, J Docherty, M Lim, K Walker, A Watson, M Hossack, N Mackenzie, M Paraoan, N Alam, I Daniels, S Narang, S Pathak, N Smart, A Al Qaddo, R Codd, O Rutka, G Williams, C Bronder, I Crighton, E Davies, T Raymond, L Bookless, B Griffiths, S Plusa, G Carlson, R Harrison, N Lees, C Mason, J Quayle, G Branagan, J Broadhurst, H Chave, S Sleight, F Awad, A Bhangu, N Cruickshank, H Joy, C Boereboom, P Daliya, A Dhillon, N Watson, R Watson, D Artioukh, K Gokul, M Javed, R Kong, J Sutton, O Faiz, I Jenkins, C A Leo, S F Samaranayake, J Warusavitarne, S Arya, C Bhan, H Mukhtar, A Oshowo, J Wilson, S Duff, T Fatayer, J Mbuvi, A Sharma, J Cornish, L Davies, R Harries, C Morris, J Torkington, J Knight, C Lai, O Shihab, A Tzivanakis, A Hussain, D Luke, R Padwick, A Torrance, A Tsiamis, P Dawson, A Balfour, R Brady, J Mander, H Paterson, N Chandratreya, H Chu, J Cutting, S Vernon, C Wai Ho, S Andreani, H Patel, M Warner, Y Q Tan, A Iqbal, A Khan, K Perrin, A Raza, S Tan

Abstract

Background: Right hemicolectomy or ileocecal resection are used to treat benign conditions like Crohn's disease (CD) and malignant ones like colon cancer (CC).

Aim: To investigate differences in pre- and peri-operative factors and their impact on post-operative outcome in patients with CC and CD.

Methods: This is a sub-group analysis of the European Society of Coloproctology's prospective, multi-centre snapshot audit. Adult patients with CC and CD undergoing right hemicolectomy or ileocecal resection were included. Primary outcome measure was 30-d post-operative complications. Secondary outcome measures were post-operative length of stay (LOS) at and readmission.

Results: Three hundred and seventy-five patients with CD and 2,515 patients with CC were included. Patients with CD were younger (median = 37 years for CD and 71 years for CC (P < 0.01), had lower American Society of Anesthesiology score (ASA) grade (P < 0.01) and less comorbidity (P < 0.01), but were more likely to be current smokers (P < 0.01). Patients with CD were more frequently operated on by colorectal surgeons (P < 0.01) and frequently underwent ileocecal resection (P < 0.01) with higher rate of de-functioning/primary stoma construction (P < 0.01). Thirty-day post-operative mortality occurred exclusively in the CC group (66/2515, 2.3%). In multivariate analyses, the risk of post-operative complications was similar in the two groups (OR 0.80, 95%CI: 0.54-1.17; P = 0.25). Patients with CD had a significantly longer LOS (Geometric mean 0.87, 95%CI: 0.79-0.95; P < 0.01). There was no difference in re-admission rates. The audit did not collect data on post-operative enhanced recovery protocols that are implemented in the different participating centers.

Conclusion: Patients with CD were younger, with lower ASA grade, less comorbidity, operated on by experienced surgeons and underwent less radical resection but had a longer LOS than patients with CC although complications' rate was not different between the two groups.

Keywords: Bowel resection; Colon cancer; Complications; Crohn’s disease; Length of stay; Right hemicolectomy.