Laparoscopic ileo-colic resection and right hemicolectomy for Crohn's disease and colon cancer: a preliminary comparative study on post-operative outcome.

ABSTRACT

Crohn's disease (CD) patients are generally considered at high risk of post-operative complications with respect to non-CD patients. The primary endpoint of this study is to compare early major complications rates between CD and colon cancer (CC) patients undergoing mini-invasive ileo-colic resections or right hemicolectomies. The secondary endpoint is to evaluate the role of pre-operative medication with anti-TNF as a possible risk factor for post-operative complications. An observational retrospective study was carried on patients who underwent mini-invasive ileocolic resections for CD and right hemicolectomies for CC at Digestive Surgery Unit and IBD Unit, Careggi Univeristy Hospital, from January 1, 2008, to June 1, 2019. Data collected included demographic and clinical informations, pre-operative anti-TNF use, major complications and mortality. Hundred and thirty-three mini-invasive ileocolic resections for CD and 131 mini-invasive right hemicolectomies for CC were included. Early major post-operative complications rates were 4.5% for CD patients and 3% for CC patients (p = 0.535). Anastomotic leak rates were 1.5% in both groups. There was no significant difference in mean length of stay; while, mean operation time was significantly longer in CD patients (p < 0.01). Pre-operative use of anti-TNF was not associated with a higher risk for early major post-operative complications in CD patients. In our institution, CD patients undergoing ileocolic resections or right hemicolectomies with a mini-invasive technique do not have a significantly higher risk of postoperative major complications with respect to CC patients, even when treated with anti-TNF agents within 3 months before surgery.