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Exploring the Relationship between Biologics and Postoperative Surgical Morbidity in Ulcerative Colitis: A Review

Background: With the paradigm shift related to the overspread use of biological agents in the treatment of inflammatory bowel diseases (IBD), several questions emerged from the surgical perspective. Whether the use of biologicals would be associated with higher rates of postoperative complications i...

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Autores principales: Quaresma, Abel Botelho, Baraúna, Fernanda da Silva Barbosa, Teixeira, Fábio Vieira, Saad-Hossne, Rogério, Kotze, Paulo Gustavo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916930/
https://www.ncbi.nlm.nih.gov/pubmed/33670200
http://dx.doi.org/10.3390/jcm10040710
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author Quaresma, Abel Botelho
Baraúna, Fernanda da Silva Barbosa
Teixeira, Fábio Vieira
Saad-Hossne, Rogério
Kotze, Paulo Gustavo
author_facet Quaresma, Abel Botelho
Baraúna, Fernanda da Silva Barbosa
Teixeira, Fábio Vieira
Saad-Hossne, Rogério
Kotze, Paulo Gustavo
author_sort Quaresma, Abel Botelho
collection PubMed
description Background: With the paradigm shift related to the overspread use of biological agents in the treatment of inflammatory bowel diseases (IBD), several questions emerged from the surgical perspective. Whether the use of biologicals would be associated with higher rates of postoperative complications in ulcerative colitis (UC) patients still remains controversial. Aims: We aimed to analyze the literature, searching for studies that correlated postoperative complications and preoperative exposure to biologics in UC patients, and synthesize these data qualitatively in order to check the possible impact of biologics on postoperative surgical morbidity in this population. Methods: Included studies were identified by electronic search in the PUBMED database according to the PRISMA (Preferred Items of Reports for Systematic Reviews and Meta-Analysis) guidelines. The quality and bias assessments were performed by MINORS (methodological index for non-randomized studies) criteria for non-randomized studies. Results: 608 studies were initially identified, 22 of which were selected for qualitative evaluation. From those, 19 studies (17 retrospective and two prospective) included preoperative anti-TNF. Seven described an increased risk of postoperative complications, and 12 showed no significant increase postoperative morbidity. Only three studies included surgical UC patients with previous use of vedolizumab, two retrospective and one prospective, all with no significant correlation between the drug and an increase in postoperative complication rates. Conclusions: Despite conflicting results, most studies have not shown increased complication rates after abdominal surgical procedures in patients with UC with preoperative exposure to biologics. Further prospective studies are needed to better establish the impact of preoperative biologics and surgical complications in UC.
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spelling pubmed-79169302021-03-01 Exploring the Relationship between Biologics and Postoperative Surgical Morbidity in Ulcerative Colitis: A Review Quaresma, Abel Botelho Baraúna, Fernanda da Silva Barbosa Teixeira, Fábio Vieira Saad-Hossne, Rogério Kotze, Paulo Gustavo J Clin Med Review Background: With the paradigm shift related to the overspread use of biological agents in the treatment of inflammatory bowel diseases (IBD), several questions emerged from the surgical perspective. Whether the use of biologicals would be associated with higher rates of postoperative complications in ulcerative colitis (UC) patients still remains controversial. Aims: We aimed to analyze the literature, searching for studies that correlated postoperative complications and preoperative exposure to biologics in UC patients, and synthesize these data qualitatively in order to check the possible impact of biologics on postoperative surgical morbidity in this population. Methods: Included studies were identified by electronic search in the PUBMED database according to the PRISMA (Preferred Items of Reports for Systematic Reviews and Meta-Analysis) guidelines. The quality and bias assessments were performed by MINORS (methodological index for non-randomized studies) criteria for non-randomized studies. Results: 608 studies were initially identified, 22 of which were selected for qualitative evaluation. From those, 19 studies (17 retrospective and two prospective) included preoperative anti-TNF. Seven described an increased risk of postoperative complications, and 12 showed no significant increase postoperative morbidity. Only three studies included surgical UC patients with previous use of vedolizumab, two retrospective and one prospective, all with no significant correlation between the drug and an increase in postoperative complication rates. Conclusions: Despite conflicting results, most studies have not shown increased complication rates after abdominal surgical procedures in patients with UC with preoperative exposure to biologics. Further prospective studies are needed to better establish the impact of preoperative biologics and surgical complications in UC. MDPI 2021-02-11 /pmc/articles/PMC7916930/ /pubmed/33670200 http://dx.doi.org/10.3390/jcm10040710 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Quaresma, Abel Botelho
Baraúna, Fernanda da Silva Barbosa
Teixeira, Fábio Vieira
Saad-Hossne, Rogério
Kotze, Paulo Gustavo
Exploring the Relationship between Biologics and Postoperative Surgical Morbidity in Ulcerative Colitis: A Review
title Exploring the Relationship between Biologics and Postoperative Surgical Morbidity in Ulcerative Colitis: A Review
title_full Exploring the Relationship between Biologics and Postoperative Surgical Morbidity in Ulcerative Colitis: A Review
title_fullStr Exploring the Relationship between Biologics and Postoperative Surgical Morbidity in Ulcerative Colitis: A Review
title_full_unstemmed Exploring the Relationship between Biologics and Postoperative Surgical Morbidity in Ulcerative Colitis: A Review
title_short Exploring the Relationship between Biologics and Postoperative Surgical Morbidity in Ulcerative Colitis: A Review
title_sort exploring the relationship between biologics and postoperative surgical morbidity in ulcerative colitis: a review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916930/
https://www.ncbi.nlm.nih.gov/pubmed/33670200
http://dx.doi.org/10.3390/jcm10040710
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