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Article ; Online: Factors associated with stoma formation in ileocolic resection for Crohn's disease and the development of a predictive scoring system.

Wickramasinghe, Dakshitha / Carvello, Michele / Di Candido, Francesca / Maroli, Annalisa / Adegbola, Samuel / Sahnan, Kapil / Morar, Pritesh / Spinelli, Antonino / Warusavitarne, Janindra

Langenbeck's archives of surgery

2022 Volume 407, Issue 7, Page(s) 2997–3003

Abstract: Purpose: The likelihood of a stoma following ileocolic resection (ICR) for Crohn's disease (CD) is an important consideration. This study aims to identify the factors associated with an increased likelihood of a stoma and develop a predictive scoring ... ...

Abstract	Purpose: The likelihood of a stoma following ileocolic resection (ICR) for Crohn's disease (CD) is an important consideration. This study aims to identify the factors associated with an increased likelihood of a stoma and develop a predictive scoring system (SS). Methods: Patient data were collected from St. Marks Hospital, London, UK and Humanitas Clinical and Research Center, Milan, Italy, on all patients who underwent an ICR for CD from 2005 to 2017. A logistic regression analysis was used for multivariate analysis. The SS was developed from the logistic regression model. The performance of the SS was evaluated using receiver operating characteristics area under the curve (AUROC). Results: A total of 628 surgeries were included in the analysis. Sixty-nine surgeries were excluded due to missing data. The remaining 559 were divided into two cohorts for the scoring system's development (n = 434) and validation (n = 125). The regression model was statistically significant (p < 0.0001). The statistically significant independent variables included sex, preoperative albumin and haemoglobin levels, surgical access and simultaneous colonic resection. The AUROC for the development and validation cohorts were 0.803 and 0.905, respectively (p < 0.0001). Youden's index suggested the cut-off score of - 95.9, with a sensitivity of 87.6% and a specificity of 62.9%. Conclusions: Male sex, low preoperative albumin, anaemia, laparoscopic conversion and simultaneous colonic resection were associated with an increased likelihood of requiring a stoma and were used to develop an SS. The calculator is available online at https://rebrand.ly/CrohnsStoma .
MeSH term(s)	Humans ; Male ; Crohn Disease/surgery ; Colectomy ; Anastomosis, Surgical ; Colon/surgery ; Albumins ; Retrospective Studies
Chemical Substances	Albumins
Language	English
Publishing date	2022-07-29
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-022-02626-1
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Article: Right sided diverticulitis in western countries: A review.

Epifani, Angelo Gabriele / Cassini, Diletta / Cirocchi, Roberto / Accardo, Caterina / Di Candido, Francesca / Ardu, Massimiliano / Baldazzi, Gianandrea

World journal of gastrointestinal surgery

2022 Volume 13, Issue 12, Page(s) 1721–1735

Abstract: Background: Although the treatment guidelines for left sided diverticulitis are clear, the management of right colonic diverticulitis is not well established. This disease can no longer be ignored due to significant spread throughout Asia.: Aim: To ... ...

Abstract	Background: Although the treatment guidelines for left sided diverticulitis are clear, the management of right colonic diverticulitis is not well established. This disease can no longer be ignored due to significant spread throughout Asia. Aim: To analyse epidemiology, diagnosis and treatment of right-sided diverticulitis in western countries. Methods: MEDLINE and PubMed searches were performed using the key words "right-sided diverticulitis'', ''right colon diverticulitis'', ''caecal diverticulitis'', ''ascending colon diverticulitis'' and ''caecum diverticula'' in order to find relevant articles published until 2021. Results: A total of 18 studies with 422 patients were found. Correct diagnosis was made only in 32.2%, mostly intraoperatively or Conclusion: The management of right- sided diverticulitis is not well clarified in the western world and no selective guidelines have been considered even if principles are similar to those with left- sided diverticulitis. Wrong diagnosis is one of the most important problems and CT scan seems to be the best imaging modality. NOM offers a safe and effective treatment; surgery should be considered only in cases of complicated diverticulitis or if malignancy cannot be excluded. Further studies are needed to clarify the correct treatment.
Language	English
Publishing date	2022-01-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	2573700-4
ISSN	1948-9366
ISSN	1948-9366
DOI	10.4240/wjgs.v13.i12.1721
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Article: Fistula Between a Primary Sigmoid Large B-Cell Lymphoma and an Ovarian Teratoma.

Accardo, Caterina / Ardu, Massimiliano / Di Candido, Francesca / Epifani, Gabriele / Cassini, Diletta / Bono, Francesca / Baldazzi, Gianandrea

ACG case reports journal

2022 Volume 9, Issue 6, Page(s) e00794

Abstract: Primary colorectal lymphoma is a rare neoplasm. We report the case of a fistula between a diffuse large B-cell lymphoma of the sigmoid colon and an ovarian teratoma. An emergent laparotomy for an acute abdomen in a 90-year-old woman was performed. A ... ...

Abstract	Primary colorectal lymphoma is a rare neoplasm. We report the case of a fistula between a diffuse large B-cell lymphoma of the sigmoid colon and an ovarian teratoma. An emergent laparotomy for an acute abdomen in a 90-year-old woman was performed. A pelvic mass of 12 × 9 cm fistulized in the left colon was found with the presence of gas and free liquid within the abdomen. This is an extremely rare condition, and as far as we know, no cases of a fistula between a large B-cell colonic lymphoma and an ovarian teratoma are present in the literature.
Language	English
Publishing date	2022-06-22
Publishing country	United States
Document type	Case Reports
ZDB-ID	2814825-3
ISSN	2326-3253
ISSN	2326-3253
DOI	10.14309/crj.0000000000000794
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Article ; Online: A scoring system to predict a prolonged length of stay after surgery for Crohn's disease.

Wickramasinghe, Dakshitha / Adegbola, Samuel / Sahnan, Kapil / Morar, Pritesh / Carvello, Michele / Di Candido, Francesca / Maroli, Annalisa / Spinelli, Antonino / Warusavitarne, Janindra

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2021 Volume 23, Issue 5, Page(s) 1205–1212

Abstract: Aim: Many factors influence the postoperative length of stay (LOS) in Crohn's disease (CD). This study aims to identify the factors associated with a prolonged LOS after ileocolic resection (ICR) for CD and to develop a scoring system to predict the ... ...

Abstract	Aim: Many factors influence the postoperative length of stay (LOS) in Crohn's disease (CD). This study aims to identify the factors associated with a prolonged LOS after ileocolic resection (ICR) for CD and to develop a scoring system to predict the postoperative LOS in CD. Method: Patient data were collected from St Marks Hospital, London, UK, and the Humanitas Clinical and Research Center Milan, Italy, for all patients who underwent an ICR for CD from 2005 to 2017. Logistic regression was used for multivariate analysis. The scoring system was developed from the logistic regression model. The performance of the scoring system was evaluated using the area under the receiver operating characteristic curve (AUROC). Results: A total of 628 surgeries were included in the analysis. Eighty eight surgeries were excluded due to missing data. The remaining 543 were divided into two cohorts for the development (n = 418) and validation (n = 125) of the scoring system. The regression model was statistically significant (p < 0.0001). The statistically significant independent variables included the time since diagnosis, American Society of Anesthesiologists (ASA) grade, perioperative use of steroids, surgical access, strictureplasty and platelet count. The AUROCs for the development and validation cohorts were 0.732 and 0.7, respectively (p < 0.0001). The cut-off score suggested by Youden's index was 50, with a sensitivity of 65.6% and a specificity of 73.3%. Conclusion: The time since diagnosis, ASA grade, steroid use, surgical access, strictureplasty and platelet count were associated with a prolonged LOS and were used to develop a scoring system. The calculator is available online at https://rebrand.ly/Crohnscal.
MeSH term(s)	Anastomosis, Surgical ; Colectomy ; Crohn Disease/surgery ; Humans ; Length of Stay ; Postoperative Period ; Retrospective Studies
Language	English
Publishing date	2021-02-20
Publishing country	England
Document type	Journal Article
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.15567
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Article ; Online: Frailty assessment can predict textbook outcomes in senior adults after minimally invasive colorectal cancer surgery.

Taffurelli, Giovanni / Montroni, Isacco / Ghignone, Federico / Zattoni, Davide / Garutti, Anna / Di Candido, Francesca / Mazzotti, Federico / Frascaroli, Giacomo / Tamberi, Stefano / Ugolini, Giampaolo

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

2022 Volume 49, Issue 3, Page(s) 626–632

Abstract: Aim: Colorectal cancer (CRC) surgery can be associated with suboptimal outcomes in older patients. The aim was to identify the correlation between frailty and surgical variables with the achievement of Textbook Outcome (TO), a composite measure of the ... ...

Abstract	Aim: Colorectal cancer (CRC) surgery can be associated with suboptimal outcomes in older patients. The aim was to identify the correlation between frailty and surgical variables with the achievement of Textbook Outcome (TO), a composite measure of the ideal postoperative course, by older patients with CRC. Method: All consecutive patients ≥70years who underwent elective CRC-surgery between January 2017 and November 2021 were analyzed from a prospective database. To obtain a TO, all the following must be achieved: 90-day survival, Clavien-Dindo (CD) < 3, no reintervention, no readmission, no discharge to rehabilitation facility, no changes in the living situation and length of stay (LOS) ≤5days/≤14days for colon and rectal surgery respectively. Frailty and surgical variables were related to the achievement of TO. Results: Four-hundred-twenty-one consecutive patients had surgery (97.7% minimally invasive), 24.9% for rectal cancer, median age 80 years (range 70-92), median LOS of 4 days (range 1-96). Overall, 288/421 patients (68.4%) achieved a TO. CD 3-4 complications rate was 6.4%, 90-day mortality rate was 2.9%. At univariate analysis, frailty and surgical variables (ileostomy creation, p = 0.045) were related to. However, multivariate analysis showed that only frailty measures such as flemish Triage Risk Screening Tool≥2 (OR 1.97, 95%CI: 1.23-3.16; p = 0.005); Charlson Index>6 (OR 1.61, 95%CI: 1.03-2.51; p = 0.036) or Timed-Up-and-Go>20 s (OR 2.06, 95%CI: 1.01-4.19; p = 0.048) independently predicted an increased risk of not achieving a TO. Conclusion: The association between frailty and comprehensive surgical outcomes offers objective data for guiding family counseling, managing expectations and discussing the possible loss of independence with patients and caregivers.
MeSH term(s)	Humans ; Adult ; Aged ; Aged, 80 and over ; Frailty/complications ; Retrospective Studies ; Postoperative Complications/etiology ; Digestive System Surgical Procedures/adverse effects ; Length of Stay ; Colorectal Neoplasms/surgery ; Risk Factors ; Geriatric Assessment ; Risk Assessment
Language	English
Publishing date	2022-11-08
Publishing country	England
Document type	Journal Article
ZDB-ID	632519-1
ISSN	1532-2157 ; 0748-7983
ISSN (online)	1532-2157
ISSN	0748-7983
DOI	10.1016/j.ejso.2022.11.006
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Article ; Online: The trend of C-Reactive protein allows a safe early discharge after surgery for Crohn's disease.

Carvello, Michele / Di Candido, Francesca / Greco, Massimiliano / Foppa, Caterina / Maroli, Annalisa / Fiorino, Gionata / Cecconi, Maurizio / Danese, Silvio / Spinelli, Antonino

Updates in surgery

2020 Volume 72, Issue 4, Page(s) 985–989

Abstract: Postoperative C-reactive protein (CRP) level allows to rule out infectious complications ensuring safe hospital discharge in colorectal cancer surgery. Since its clinical significance in Crohn's disease (CD) has not been studied yet, we investigated ... ...

Abstract	Postoperative C-reactive protein (CRP) level allows to rule out infectious complications ensuring safe hospital discharge in colorectal cancer surgery. Since its clinical significance in Crohn's disease (CD) has not been studied yet, we investigated whether CRP can guide decision-making on hospital discharge in this population. Only consecutive CD patients undergoing resections with primary anastomosis and without covering stoma (2013-2017) were analysed. Pre- and post-operative CRP values, measured daily until discharge, were correlated with postoperative complications including anastomotic leakage (AL), infectious and non-infectious complications. The diagnostic accuracy of CRP in predicting AL was evaluated according to the area under the curve (AUC), using the receiver-operating characteristic (ROC) methodology. Two-hundred and fifty-one consecutive patients undergoing elective surgery for CD were selected. AL was diagnosed in 10 patients (4%). High CRP level was associated with AL on postoperative day (POD) 3-5 (p = 0.002, AUC 0.825) with a positive predictive value of 60%. CRP linear difference of 140 between POD 1 and 3 (AUC 0.800) maximizes sensitivity and specificity with a NPV of 98.6%. CRP trend, measured with the linear difference between POD 1 and 3, is able to rule out anastomotic complications with a high NPV and may allow a safe early hospital discharge after surgery for CD.
MeSH term(s)	Adult ; Anastomotic Leak/diagnosis ; Biomarkers/blood ; C-Reactive Protein/analysis ; Clinical Decision-Making/methods ; Communicable Diseases/diagnosis ; Crohn Disease/surgery ; Female ; Humans ; Male ; Middle Aged ; Patient Discharge ; Postoperative Complications/diagnosis ; Predictive Value of Tests ; ROC Curve ; Retrospective Studies ; Safety ; Sensitivity and Specificity ; Time Factors
Chemical Substances	Biomarkers ; C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2020-05-13
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-020-00789-4
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Article ; Online: Segmental Colonic Resection Is a Safe and Effective Treatment Option for Colon Cancer of the Splenic Flexure: A Nationwide Retrospective Study of the Italian Society of Surgical Oncology-Colorectal Cancer Network Collaborative Group.

Degiuli, Maurizio / Reddavid, Rossella / Ricceri, Fulvio / Di Candido, Francesca / Ortenzi, Monica / Elmore, Ugo / Belluco, Claudio / Rosati, Riccardo / Guerrieri, Marco / Spinelli, Antonino

Diseases of the colon and rectum

2020 Volume 63, Issue 10, Page(s) 1372–1382

Abstract: Background: Global experience with splenic flexure cancer is limited because of its low incidence. Both limited (segmental) and extended resections are performed, because agreement on which is the adequate procedure has not been reached.: Objective: ... ...

Abstract	Background: Global experience with splenic flexure cancer is limited because of its low incidence. Both limited (segmental) and extended resections are performed, because agreement on which is the adequate procedure has not been reached. Objective: The purpose of this study was to investigate whether segmental resection is as safe and effective as extended resection. Design: This nationwide retrospective cohort study included all consecutive resections of splenic flecure cancer between January 2006 and December 2016 using data from the National Colorectal Cancer Network of the Italian Society of Surgical Oncology following the guidelines set out in the STROBE statement. Setting: Data were obtained for 31 Italian Referral Centers for Colorectal Surgery. Patients: A total of 1304 patients were submitted to resection of the splenic flexure (n = 791, 60.7%) or extended procedures (extended right and left colectomies; n = 513, 39.3%). Main outcome measures: We evaluated Clavien-Dindo ≥3 postoperative complications and oncological (number of lymph nodes removed, length of free proximal and distal margins, rate of R0 resections) and survival outcomes. Results: The 2 arms were well balanced in regard to sex, BMI, ASA and Eastern Cooperative Oncology Group scores, and disease stage. Limited resection was performed more frequently using a minimally invasive approach (62.1% vs 50.9%, p < 0.001) and with shorter operation times than extended procedures (165 vs 189 minutes, p < 0.001), but the same Clavien-Dindo ≥3 postoperative complications (6.44% vs 6.43%, p = 0.99), 30-day mortality (0.63% vs 0.38%), oncological outcomes, and survival rates (5-year overall survival 0.84 vs 0.83, 5-year progression-free survival 0.85 vs 0.84). Limitations: There are limitations inherent to the retrospective nature of the study and a potential lack of consistency in treatment across centers over time. Indications as to why a specific operation was chosen were based mostly on surgeons' beliefs. Conclusions: Segmental resection is a safe and effective treatment option for cancer of the splenic flexure. See Video Abstract at http://links.lww.com/DCR/B307. LA RESECCIÓN DE COLON SEGMENTARIA ES UNA OPCIÓN DE TRATAMIENTO SEGURA Y EFICAZ PARA EL CÁNCER DE COLON DE LA FLEXIÓN ESPLÉNICA: UN ESTUDIO RETROSPECTIVO A NIVEL NACIONAL DE LA SOCIEDAD ITALIANA DE ONCOLOGÍA QUIRÚRGICA - GRUPO COLABORATIVO RED DE CÁNCER COLORRECTAL: La experiencia global con el cáncer de flexión esplénica es limitada debido a su baja incidencia. Se realizan resecciones limitadas (segmentarias) y extendidas, ya que no se ha llegado a un acuerdo sobre cuál es el procedimiento adecuado.El propósito de este estudio fue investigar si la resección segmentaria es tan segura y efectiva como la resección extendida.Este estudio de cohorte retrospectivo a nivel nacional incluyó todas las resecciones consecutivas de cáncer de flecura esplénica entre enero de 2006 y diciembre de 2016 utilizando datos de la Red Nacional de Cáncer Colorrectal de la Sociedad Italiana de Oncología Quirúrgica siguiendo las pautas establecidas en la declaración STROBE.Se obtuvieron datos para 31 centros de referencia italianos para cirugía colorrectal.Un total de 1304 pacientes fueron sometidos a resección de la flexión esplénica (n = 791, 60.7%) o procedimientos extendidos (colectomías extendidas derecha e izquierda; n = 513, 39.3%).Evaluamos Clavien-Dindo ≥3 complicaciones postoperatorias y oncológicas (número de ganglios linfáticos extirpados, longitud de márgenes proximales y distales libres, tasa de resecciones R0) y resultados de supervivencia.Los dos brazos estaban bien equilibrados en cuanto a sexo, IMC, ASA y puntajes ECOG, y etapa de la enfermedad. La resección limitada se realizó con mayor frecuencia utilizando un enfoque mínimamente invasivo (62.1% versus 50,9%, p < 0.001) y con tiempos de operación más cortos que los procedimientos extendidos (165 min versus 189 min, p <0.001), pero el mismo Clavien-Dindo ≥3 complicaciones postoperatorias (6,44% versus 6,43%, p = 0.99), mortalidad a los 30 días (0,63% versus 0,38%), resultados oncológicos y tasas de supervivencia (5-y OS 0,84 versus 0,83, 5-PFS 0,85 versus 0,84).Existen limitaciones inherentes a la naturaleza retrospectiva del estudio y una posible falta de consistencia en el tratamiento entre centros a lo largo del tiempo. Las indicaciones de por qué se eligió una operación específica se basaron principalmente en crieterios de los cirujanos.La resección segmentaria es una opción de tratamiento segura y efectiva para el cáncer de la flexión esplénica. Consulte Video Resumen en http://links.lww.com/DCR/B307. (Traducción-Dr. Adrian Ortega).
MeSH term(s)	Aged ; Colectomy/methods ; Colon, Transverse/surgery ; Colonic Neoplasms/mortality ; Colonic Neoplasms/pathology ; Colonic Neoplasms/surgery ; Female ; Humans ; Italy ; Lymph Node Excision ; Male ; Margins of Excision ; Neoplasm Staging ; Postoperative Complications ; Retrospective Studies ; Survival Rate
Language	English
Publishing date	2020-09-22
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Video-Audio Media
ZDB-ID	212581-x
ISSN	1530-0358 ; 0012-3706
ISSN (online)	1530-0358
ISSN	0012-3706
DOI	10.1097/DCR.0000000000001743
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Article ; Online: A comparative cost analysis of transanal and laparoscopic total mesorectal excision for rectal cancer.

Di Candido, Francesca / Carvello, Michele / Keller, Deborah S / Vanni, Elena / Maroli, Annalisa / Montroni, Isacco / Hompes, Roel / Sacchi, Matteo / Montorsi, Marco / Spinelli, Antonino

Updates in surgery

2020 Volume 73, Issue 1, Page(s) 85–91

Abstract: Despite proven clinical benefits in the short term, technical difficulties limit utilization of laparoscopy in rectal cancer surgery (RCS). Transanal Total Mesorectal Excision (taTME) overcomes many technical limitations of laparoscopic RCS. However, the ...

Abstract	Despite proven clinical benefits in the short term, technical difficulties limit utilization of laparoscopy in rectal cancer surgery (RCS). Transanal Total Mesorectal Excision (taTME) overcomes many technical limitations of laparoscopic RCS. However, the costs of this procedure have not been addressed yet. Our goal was to perform a comparative cost analysis of taTME and laparoscopic TME (lapTME). Consecutive patients undergoing curative TME between 1 February 2014 and 31 October 2018 were selected from a prospectively maintained database and stratified, according to the type of procedure, into taTME and lapTME groups. Patient demographics, tumour characteristics, operative parameters, and short-term outcomes were analyzed. The main outcome measure was intraoperative costs of the two procedures. Secondary outcomes were short-term outcome and the utilization of hospital resources to manage the postoperative course. Hundred and fifty-two patients with rectal cancer (66 lapTME, 86 taTME) were included in the study. Surgical supplies required for taTME procedure exceeded the cost of lapTME of 754,54 €. The duration of surgery was not significantly different between the two approaches (266 ± 92.85 vs 271 ± 83.63, p = 0.50). Short-term outcomes were comparable including postoperative complication rate (17 vs 20%, p = 0.68), reintervention rate, and length of stay. There was no difference in hospital resources utilization to manage postoperative course including blood test, diagnostics, consultations, and medications. TaTME has higher intraoperative costs in terms of supplies with respect to lapTME. Short-term outcomes and hospital resources to manage postoperative course are comparable.
MeSH term(s)	Aged ; Costs and Cost Analysis ; Digestive System Surgical Procedures/economics ; Digestive System Surgical Procedures/methods ; Female ; Health Resources/economics ; Humans ; Laparoscopy/economics ; Laparoscopy/methods ; Length of Stay/economics ; Male ; Middle Aged ; Perioperative Care/economics ; Postoperative Complications/economics ; Postoperative Complications/epidemiology ; Rectal Neoplasms/economics ; Rectal Neoplasms/surgery ; Treatment Outcome
Language	English
Publishing date	2020-09-14
Publishing country	Italy
Document type	Comparative Study ; Journal Article
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-020-00879-3
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Article ; Online: Watchful Waiting After Radiological Guided Drainage of Intra-abdominal Abscess in Patients With Crohn's Disease Might Be Associated With Increased Rates of Stoma Construction.

El-Hussuna, Alaa / Steenholdt, Casper / Merrild Karer, Mette Louise / Nyggard Uldall Nielsen, Natasja / Mujukian, Angela / Fleshner, Phillip R / Iesalnieks, Igors / Horesh, Nir / Kopylov, Uri / Jacoby, Harel / Al-Qaisi, Haider Mahmoud / Colombo, Francesco / Sampietro, Gianluca M / Marino, Marco V / Ellebæk, Mark / Sørensen, Nina / Celentano, Valerio / Ladwa, Nikhil / Warusavitarne, Janindra /

Pellino, Gianluca / Zeb, Aurang / Di Candido, Francesca / Hurtado-Pardo, Luis / Frasson, Matteo / Kunovsky, Lumir / Yalcinkaya, Ali / Alonso, Sandra / Pera, Miguel / Rodríguez, Cristina Antón / Bravo, Ana-Minaya / Granero, Alvaro Garcia / Tatar, Ozan Can / Spinelli, Antonino / Qvist, Niels

Crohn's & colitis 360

2023 Volume 5, Issue 3, Page(s) otad038

Abstract: Background: Management of spontaneous intra-abdominal abscess (IAA) in patients with Crohn's disease (CD) with radiologically guided percutaneous drainage (PD) was debated.: Methods: This is a secondary analysis from a multicenter, retrospective ... ...

Abstract	Background: Management of spontaneous intra-abdominal abscess (IAA) in patients with Crohn's disease (CD) with radiologically guided percutaneous drainage (PD) was debated. Methods: This is a secondary analysis from a multicenter, retrospective cohort study of all the patients with CD who underwent PD followed by surgery at 19 international tertiary centers. Results: Seventeen patients (4.8%) who did not undergo surgery after PD were compared to those who had PD followed by surgical intervention 335/352 (95.2%). Patients who had PD without surgery were those with longer disease duration, more frequently had previous surgery for CD (laparotomies/laparoscopies), enteric fistula, on steroid treatment before and continue to have it after PD. Patients who had PD without subsequent surgical resection had a higher risk of stoma construction at later stages 8/17 (47.1%) versus 90/326 (27.6%) ( Conclusions: Even with the low number of patients enrolled in this study who had PD of IAA without subsequent surgery, the findings indicate a markedly worse prognosis in terms of recurrence, length of stay, readmission, and stoma construction. Watchful waiting after PD to treat patients with spontaneous IAA might be indicated in selected patients with poor health status or poor prognostic factors.
Language	English
Publishing date	2023-07-19
Publishing country	England
Document type	Journal Article
ISSN	2631-827X
ISSN (online)	2631-827X
DOI	10.1093/crocol/otad038
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Article ; Online: Risk factors for locally advanced cancer associated with ulcerative colitis: Results of a retrospective multicentric study in the era of biologics.

Rottoli, Matteo / Tanzanu, Marta / Di Candido, Francesca / Colombo, Francesco / Frontali, Alice / Chandrasinghe, Pramodh C / Pellino, Gianluca / Frasson, Matteo / Warusavitarne, Janindra / Panis, Yves / Sampietro, Gianluca M / Spinelli, Antonino / Poggioli, Gilberto

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

2019 Volume 52, Issue 1, Page(s) 33–37

Abstract: Background: Patients affected by ulcerative colitis (UC) are more likely to develop colorectal cancer, and are often diagnosed with lymph node involvement (N+) at surgery.: Aim: To identify the risk factors for N+ cancer in UC patients.: Methods: ... ...

Abstract	Background: Patients affected by ulcerative colitis (UC) are more likely to develop colorectal cancer, and are often diagnosed with lymph node involvement (N+) at surgery. Aim: To identify the risk factors for N+ cancer in UC patients. Methods: Patients undergoing surgery from 2001 to 2018 in six European tertiary centres were included. N+ patients were compared to the control group (N-) for clinical variables. The evaluation of risk factors for N+ was assessed using univariate and multivariable logistic regression analyses. Results: A total of 130 patients were included. Median duration of disease was 21 years (1-52). Forty patients (30.8%) were N+ at surgery. Eighteen (13.8%) developed cancer within 10 years from the onset of UC. Younger age at surgery (Odds ratio -OR- 0.96, p = 0.042), left colon location (OR 2.44, p = 0.045) and the presence of stricture (OR 5.07, p = 0.002) were associated with N+. Conclusion: Location in the left colon, presence of strictures and younger age strongly correlated with a higher risk of N+ cancer, which could develop before the starting point of surveillance. Duration, extension and severity of disease were not associated with N+. These results should be considered in the evaluation of risk of advanced cancer in UC patients.
MeSH term(s)	Adolescent ; Adult ; Aged ; Child ; Colectomy/adverse effects ; Colitis, Ulcerative/complications ; Colitis, Ulcerative/surgery ; Colonoscopy/adverse effects ; Colorectal Neoplasms/epidemiology ; Colorectal Neoplasms/etiology ; Disease Progression ; Female ; Humans ; Italy ; Logistic Models ; Lymph Nodes/pathology ; Male ; Middle Aged ; Multivariate Analysis ; Retrospective Studies ; Risk Factors ; Time Factors ; Young Adult
Language	English
Publishing date	2019-09-30
Publishing country	Netherlands
Document type	Journal Article ; Multicenter Study
ZDB-ID	1459373-7
ISSN	1878-3562 ; 1125-8055
ISSN (online)	1878-3562
ISSN	1125-8055
DOI	10.1016/j.dld.2019.08.024
Database	MEDical Literature Analysis and Retrieval System OnLINE

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