Retrospective Study
Copyright ©The Author(s) 2024.
World J Gastrointest Surg. Mar 27, 2024; 16(3): 717-730
Published online Mar 27, 2024. doi: 10.4240/wjgs.v16.i3.717
Table 1 Demographic and Crohn’s disease data in patients undergoing intestinal resection
Variables
Total (n = 181)
Major postoperative complication1
P value
Yes (10)
No (171)
Sex0.281
    Male127 (70.2)5 (50.0)122 (71.3)
    Female54 (29.8)5 (50.0)49 (28.7)
Age at surgery (yr)39.04 ± 13.036.7 ± 15.739.2 ± 12.80.558
Duration of disease (yr)4.9 ± 5.25.6 ± 4.74.8 ± 5.20.454
BMI (kg/m2)19.2 ± 3.418.0 ± 3.619.2 ± 3.40.137
Weight loss > 10% in 6 months prior to surgery      0.564
Yes66 (36.5)5 (50.0)61 (35.7)
No115 (63.5)5 (50.0)110 (64.3)
History of intestinal resection0.855
Yes41 (22.7)3 (30.0)38 (22.2)
No140 (77.3)7 (70.0)133 (77.8)
Mean preoperative laboratory values
C reactive protein serum level (mg/L)31.2 ± 43.218.8 ± 12.631.9 ± 44.30.901
Erythrocyte sedimentation rate (mm/h)31.0 ± 15.438.9 ± 12.330.6 ± 15.40.071
Platelets (× 109/L)295.2 ± 124.2330.4 ± 108.4293.2 ± 125.10.230
Hemoglobin level (g/L)115.5 ± 21.3114.8 ± 30.2115.5 ± 20.70.896
Serum albumin (g/L)36.3 ± 5.731.4 ± 5.936.6 ± 5.60.005a
Preoperative therapy (< 3 months before surgery)0.075
No preoperative therapy75 (41.4)4 (40.0)71 (41.5)
Steroids2/traditional immunosuppressant349 (27.1)0 (0.0)49 (28.7)
Biologicals45 (24.9)5 (50.0)40 (23.4)
Combo therapy12 (6.6)1 (10.0)11 (6.4)
Preoperative CDAI staging0.006a
Remission to mild (< 220)103 (56.9)1 (10.0)102 (59.6)
Moderate to severe (≥ 220)78 (43.1)9 (90.0)69 (40.4)
Age at diagnosis of CD (yr)0.601
A1 (< 17)10 (5.5)1 (10.0)9 (5.3)
A2 (17-40)122 (67.4)7 (70.0)115 (67.2)
A3 (> 40)49 (27.1)2 (20.0)47 (27.5)
Disease location0.604
L1 (ileal)35 (19.3)1 (10.0)34 (19.9)
L2 (colonic)12 (6.6)1 (10.0)11 (6.4)
L3 (ileocolic)134 (74.0)8 (80.0)126 (73.7)
Disease behavior0.080
B2 (stricturing)65 (35.9)1 (10.0)64 (37.4)
B3 (penetrating)91 (50.3)6 (60.0)85 (49.7)
B2P (structuring with perianal disease)7 (3.9)0 (0.0)7 (4.1)
B3P (penetrating with perianal disease)18 (9.9)3 (30.0)15 (8.8)
Table 2 Surgical data
Variables
Total (n = 181)
Major postoperative complication1
P value
Yes (10)
No (171)
Surgical priority      0.065
Selective173 (95.6)8 (80.0)165 (96.5)
Emergency8 (4.4)2 (20.0)6 (3.5)
Surgical approach0.011a
Laparoscopic163 (90.1)6 (60.0)157 (91.8)
Open6 (3.3)1 (10.0)5 (2.9)
Conversion12 (6.6)3 (30.0)9 (5.3)
Type of resection0.309
ICR100 (55.2)5 (50.0)95 (55.6)
Right hemicolectomy25 (13.8)0 (0.0)25 (14.6)
Left-sided colectomy5 (2.8)0 (0.0)5 (2.9)
Subtotal colectomy21 (11.6)3 (30.0)18 (10.5)
Segmental resection of small bowel30 (16.6)2 (20.0)28 (16.4)
Stoma creation0.070
Yes104 (57.5)9 (90.0)95 (55.6)
No77 (42.5)1 (10.0)76 (44.4)
Operative time (min)147.7 ± 37.6182.0 ± 40.8145.7 ± 36.50.007a
Intraoperative blood loss (mL)133.1 ± 114.1195.0 ± 138.3129.5 ± 111.90.048a
Table 3 Multivariate logistic regression analysis results of factors associated with major postoperative complications (Clavien-Dindo ≥ III)
VariableMultivariate analysis
OR
95%CI
P value
Preoperative CDAI
    Remission to mild (< 220)Reference
    Moderate to severe (≥ 220)10.0841.011-100.6260.490
Serum albumin (g/L)0.8260.705-0.9680.016a
Surgical approach
    LaparoscopicReference
        Open14.1610.830-241.5720.067
        Conversion7.0001.188-41.2440.032a
Operative time (min)1.0261.008-1.0450.005a
Table 4 Related factors of postoperative hospital stay
VariableLinear regression analysis
Univariate analysis P value
Multivariate analysis P value
Sex0.798      
Age at surgery (yr)0.444
Duration of disease (yr)0.449
History of intestinal resection0.631
BMI (kg/m2)0.132
Weight loss > 10% in 6 months prior to surgery0.328
Mean preoperative laboratory values
    C reactive protein serum level (mg/L)0.087
    Erythrocyte sedimentation rate (mm/h)0.602
    Platelets (× 109/L)0.886
    Hemoglobin level (g/L)0.0560.015a
    Serum albumin (g/L)0.056
Preoperative CDAI staging0.061
Montreal classification
Age at diagnosis of CD (yr)0.574
Disease location0.342
Disease behavior0.947
Surgical priority< 0.001a0.001a
Surgical approach< 0.001a< 0.001a
Type of resection0.039a
Stoma creation0.504
Operation time (min)0.001a< 0.001a
Intraoperative blood loss (mL)0.004a