Association between preoperative tumor necrosis factor alpha inhibitor and surgical site infection after surgery for inflammatory bowel disease: a systematic review and meta-analysis

Motoi Uchino, Hiroki Ikeuchi, Junzo Shimizu, Hiroki Ohge, Seiji Haji, Toru Mizuguchi, Yasuhiko Mohri, Chizuru Yamashita, Yuichi Kitagawa, Katsunori Suzuki, Motomu Kobayashi, Masahiro Kobayashi, Fumie Sakamoto, Masahiro Yoshida, Toshihiko Mayumi, Koichi Hirata, Yoshio Takesue

Research output: Contribution to journalReview article

Abstract

Tumor necrosis factor-alpha inhibitor (TNFi) treatment is effective for ulcerative colitis (UC) and Crohn’s disease (CD). Although several meta-analyses have been performed to evaluate the association between TNFi treatment and surgical morbidity, the results are controversial. We conducted a systematic review and meta-analysis of the prevention of surgical site infection (SSI) after surgery for UC and CD in patients on TNFis, based on literature published between January 2000 and May 2019 (registered on PROSPERO, No. CRD42019134156). Overall, 2175 UC patients in 13 observational studies (OBSs) and 7084 CD patients in 16 OBSs were included. The incidences of incisional (INC) SSI and organ/space (O/S) SSI after surgery for UC were 179/1985 (9.0%) and 176/2175 (8.1%), respectively. TNFi use was not associated with the incidences of INC SSI (odds ratio (OR) 1.04, 95% confidence interval (CI) (0.47–2.32) or O/S SSI (OR 1.85, 95% CI (0.82–4.20)) after surgery for UC. The INC SSI and O/S SSI incidences after surgery for CD were 289/3089 (9.4%) and 526/7,084 (7.4%), respectively. Preoperative TNFi use was not associated with INC SSI (OR 0.98, 95% CI (0.52–1.83)) or O/S SSI incidence (OR 1.09, 95% CI (0.78–1.52)) after surgery for CD. We did not find a significant association between preoperative TNFi use and SSI in surgery for UC or CD.

Original languageEnglish
JournalSurgery today
DOIs
Publication statusAccepted/In press - 2020
Externally publishedYes

Keywords

  • Crohn’s disease
  • Postoperative complications
  • Surgical site infection
  • Tumor necrosis factor alpha inhibitor
  • Ulcerative colitis

ASJC Scopus subject areas

  • Surgery

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    Uchino, M., Ikeuchi, H., Shimizu, J., Ohge, H., Haji, S., Mizuguchi, T., Mohri, Y., Yamashita, C., Kitagawa, Y., Suzuki, K., Kobayashi, M., Kobayashi, M., Sakamoto, F., Yoshida, M., Mayumi, T., Hirata, K., & Takesue, Y. (Accepted/In press). Association between preoperative tumor necrosis factor alpha inhibitor and surgical site infection after surgery for inflammatory bowel disease: a systematic review and meta-analysis. Surgery today. https://doi.org/10.1007/s00595-020-02003-9