Hideaki Kimura1, Kenichi Takahashi2, Kitaro Futami3, Hiroki Ikeuchi4, Kenji Tatsumi5, Kazuhiro Watanabe6, Kiyoshi Maeda7, Yusuke Watadani8, Riichiro Nezu9, Hitoshi Kameyama10, Sayumi Nakao11, Kiyotaka Kurachi12, Masayuki Hotokezaka13, Koki Otsuka14, Toshiaki Watanabe15, Heita Ozawa16. 1. Inflammatory Bowel Disease Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Kanagawa, Japan. hkim@yokohama-cu.ac.jp. 2. Department of Colorectal Surgery, Tohoku Rosai Hospital, Sendai, Miyagi, Japan. 3. Department of Surgery, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan. 4. Inflammatory Bowel Disease Center, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. 5. Inflammatory Bowel Disease Center, Yokohama Municipal Citizen's Hospital, Yokohama, Kanagawa, Japan. 6. Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan. 7. Department of Surgical Oncology, Osaka City University School of Medicine, Osaka, Japan. 8. Department of Surgery, Hiroshima University, Hiroshima, Japan. 9. Department of Surgery, Nishinomiya Municipal Central Hospital, Nishinomiya, Hyogo, Japan. 10. Division of Digestive and General Surgery, Niigata University, Niigata, Japan. 11. Second Department of Surgery, Tokyo Women's Medical University, Tokyo, Japan. 12. Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan. 13. Department of Surgery, Junwakai Memorial Hospital, Miyazaki, Japan. 14. Department of Surgery, Iwate Medical University School of Medicine, Morioka, Iwate, Japan. 15. Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan. 16. Division of Colorectal Surgery, Tochigi Cancer Center, Utsunomiya, Tochigi, Japan.
Abstract
PURPOSE: The aim of the study is to assess the relationship between the introduction of biologic and immunosuppressant therapy and the number of patients undergoing surgery for ulcerative colitis (UC). METHODS: A questionnaire survey about patients undergoing surgery for UC was sent to 26 teaching hospitals throughout Japan. The questionnaire period spanned from 2008 to 2013, to account for the introduction of tacrolimus (2009) and infliximab (2010). RESULTS: The total number of patients who underwent surgery was 297, 291, 273, 255, 300, and 305 in 2008, 2009, 2010, 2011 2012, and 2013, respectively. The emergency surgery rate remained stable at 32-34 % each year. The proportion of patients who underwent surgery for cancer increased from 13.8 % in 2008 to 20 % in 2013. In 2013, 41, 38, and 6 % of patients who underwent surgery had received treatment with a biologic, tacrolimus, and cyclosporine, respectively. No institution reported an increase in postoperative complications among patients treated with immunosuppressive drugs. CONCLUSIONS: The number of patients undergoing surgery decreased temporarily soon after infliximab and tacrolimus first became widely available, but subsequently increased again. The emergency surgery rate remained unchanged throughout the study period. These data show that immunosuppressive drugs have had little effect on the risk of postoperative complications.
PURPOSE: The aim of the study is to assess the relationship between the introduction of biologic and immunosuppressant therapy and the number of patients undergoing surgery for ulcerative colitis (UC). METHODS: A questionnaire survey about patients undergoing surgery for UC was sent to 26 teaching hospitals throughout Japan. The questionnaire period spanned from 2008 to 2013, to account for the introduction of tacrolimus (2009) and infliximab (2010). RESULTS: The total number of patients who underwent surgery was 297, 291, 273, 255, 300, and 305 in 2008, 2009, 2010, 2011 2012, and 2013, respectively. The emergency surgery rate remained stable at 32-34 % each year. The proportion of patients who underwent surgery for cancer increased from 13.8 % in 2008 to 20 % in 2013. In 2013, 41, 38, and 6 % of patients who underwent surgery had received treatment with a biologic, tacrolimus, and cyclosporine, respectively. No institution reported an increase in postoperative complications among patients treated with immunosuppressive drugs. CONCLUSIONS: The number of patients undergoing surgery decreased temporarily soon after infliximab and tacrolimus first became widely available, but subsequently increased again. The emergency surgery rate remained unchanged throughout the study period. These data show that immunosuppressive drugs have had little effect on the risk of postoperative complications.
Authors: N Hiwatashi; T Yao; H Watanabe; S Hosoda; K Kobayashi; T Saito; A Terano; T Shimoyama; T Muto Journal: J Gastroenterol Date: 1995-11 Impact factor: 7.527
Authors: Gert Van Assche; Axel Dignass; Bernd Bokemeyer; Silvio Danese; Paolo Gionchetti; Gabriele Moser; Laurent Beaugerie; Fernando Gomollón; Winfried Häuser; Klaus Herrlinger; Bas Oldenburg; Julian Panes; Francisco Portela; Gerhard Rogler; Jürgen Stein; Herbert Tilg; Simon Travis; James O Lindsay Journal: J Crohns Colitis Date: 2012-10-03 Impact factor: 10.020