Surgical treatment of Crohn‘s disease in children in the era of biological treatment
Authors:
V. Dotlačil 1; R. Škába 1; B. Rousková 1; L. Poš 1; B. Kučerová 1; Š. Coufal 2; T. Lerchová 3; M. Rygl 1
Authors‘ workplace:
Klinika dětské chirurgie, 2. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice v Motole, Praha
1; Laboratoř buněčné a molekulární imunologie, Mikrobiologický ústav, Akademie věd České republiky, v. v. i., Praha
2; Pediatrická klinika, 2. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice v Motole, Praha
3
Published in:
Rozhl. Chir., 2022, roč. 101, č. 2, s. 56-60.
Category:
Review
doi:
https://doi.org/10.33699/PIS.2022.101.2.56–60
Overview
Introduction: The incidence of Crohn‘s disease in the paediatric population has been increasing and requires surgical treatment in addition to conservative therapy. While surgical treatment used to be the last step after the failure of all conservative therapies, nowadays it is a standard part of complex treatment. Surgery can enter the treatment process at any stage of the disease and, with a proper indication, timing and preoperative optimization, it can induce immediate remission in patients. On the other hand, with inadequate or improper preoperative preparation and indication, surgical treatment can cause serious or even life-threatening complications. The spectrum of patients undergoing surgery is changing in the era of biological therapy. The aim of this review was to summarize the current knowledge of the impact of biological (anti-TNF alpha) therapy on the development of postoperative complications in children and adolescents operated for Crohn‘s disease.
Methods: We present a review based on literature available in MEDLINE-PubMed and Embase databases.
Conclusion: According to current knowledge, no association was found between biological treatment in the preoperative period and the development of postoperative complications in paediatric patients. Surgical treatment of paediatric patients with Crohn‘s disease is one of standard treatment modalities.
Keywords:
inflammatory bowel disease – biological therapy – laparoscopy – Crohn‘s disease – paediatric surgery
Sources
1. Sýkora J, Pomahačová R, Kreslová M, et al. Current global trends in the incidence of pediatric-onset inflammatory bowel disease. World J Gastroenterol. 2018 Jul 7;24(25):2741−2763. doi: 10.3748/wjg. v24.i25.2741.
2. Gasparetto M, Guariso G. Highlights in IBD epidemiology and its natural history in the paediatric age. Gastroenterol Res Pract. 2013;829040. doi: 10.1155/2013/829040.
3. de Bie C, Paerregaard A, Kolacek S, et al. Disease phenotype at diagnosis in pediatric Crohn´s disease: 5-year analyses of the EUROKIDS Registry. Inflamm Bowel Dis. 2013;19(02):378–385. doi: 10.1002/ ibd.23008.
4. Mowat C, Cole A, Windsor A, et al. IBD Section of the British Society of Gastroenterology. Guidelines for the management of inflammatory bowel disease in adults. Gut 2011;60(05):571–607. doi: 10.1136/ gut.2010.224154.
5. Hyams JS, Griffiths A, Markowitz J, et al. Safety and efficacy of adalimumab for moderate to severe Crohn‘s disease in children. Gastroenterology 2012;143(2): 365−374. doi: 10.1053/j.gastro. 2012.04.046.
6. Hanauer SB, Feagan BG, Lichtenstein GR, et al. ACCENT I Study Group. Maintenance infliximab for Crohn’s disease: the ACCENT I randomised trial. Lancet 2002;359(9317):1541–1549. doi: 10.1016/ S0140-6736(02)08512-4.
7. Hanauer SB, Sandborn WJ, Rutgeerts P, et al. Human anti-tumor necrosis factor monoclonal antibody (adalimumab) in Crohn’s disease: the CLASSIC-I trial. Gastroenterology 2006;130(02):323–333. doi: 10.1053/j.gastro.2005.11.030.
8. Colombel JF, Sandborn WJ, Rutgeerts P, et al. Adalimumab for maintenance of clinical response and remission in patients with Crohn’s disease: the CHARM trial. Gastroenterology 2007;132(01):52–65. doi: 10.1053/j.gastro.2006.11.041.
9. Rutgeerts P, Feagan BG, Lichtenstein GR, et al. Comparison of scheduled and episodic treatment strategies of infliximab in Crohn’s disease. Gastroenterology 2004;126(02):402–413. doi: 10.1053/j. gastro.2003.11.014.
10. Sandborn WJ, Rutgeerts P, Enns R, et al. Adalimumab induction therapy for Crohn disease previously treated with infliximab: a randomized trial. Ann Intern Med. 2007;146(12):829–838. doi: 10.7326/0003-4819-146-12-200706190- 00159.
11. Vernier-Massouille G, Balde M, Salleron J, et al. Natural history of pediatric Crohn’s disease: a population-based cohort study. Gastroenterology 2008;135(04):1106–1113. doi: 10.1053/j. gastro.2008.06.079.
12. Amil-Dias J, Kolacek S, Turner D, et al. IBD Working Group of ESPGHAN (IBD Porto Group). Surgical management of Crohn disease in children: Guidelines from the paediatric IBD Porto Group of ESPGHAN. J Pediatr Gastroenterol Nutr. 2017 May;64(5):818−835. doi: 10.1097/ MPG.0000000000001562.
13. Pini-Prato A, Faticato MG, Barabino A, et al. Minimally invasive surgery for paediatric inflammatory bowel disease: Personal experience and literature review. World J Gastroenterol. 2015 Oct 28;21(40):11312−11320. doi: 10.3748/ wjg.v21.i40.11312. PMID: 26525138; PMCID: PMC4616207.
14. Neville JJ, Macdonald A, Fell J, et al. Therapeutic strategies for stricturing Crohn‘s disease in childhood: a systematic review. Pediatr Surg Int. 2021 May;37(5):569−577. doi: 10.1007/s00383- 020-04848-0.
15. Stewart D. Surgical care of the pediatric Crohn‘s disease patient. Semin Pediatr Surg. 2017 Dec;26(6):373−378. doi: 10.1053/j.sempedsurg.2017.10.007.
16. Quiroz HJ, Perez EA, El Tawil RA, et al. Open versus laparoscopic right hemicolectomies in pediatric patients with Crohn‘s disease. J Laparoendosc Adv Surg Tech A. 2020 Jul;30(7):820−825. doi: 10.1089/lap.2019.0814.
17. Carvello M, de Groof EJ, de Buck van Overstraeten A, et al. Single port laparoscopic ileocaecal resection for Crohn‘s disease: a multicentre comparison with multi-port laparoscopy. Colorectal Dis. 2018 Jan;20(1):53−58. doi: 10.1111/codi.13777.
18. Fazio VW, Kiran RP, Remzi FH, et al. Ileal pouch anal anastomosis: analysis of outcome and quality of life in 3707 patients. Ann Surg. 2013 Apr;257(4):679−685. doi: 10.1097/SLA.0b013e31827d99a2.
19. Forsdick VK, Tan Tanny SP, King SK. Medical and surgical management of pediatric perianal Crohn‘s disease: A systematic review. J Pediatr Surg. 2019 Dec;54(12):2554−2558. doi: 10.1016/j. jpedsurg.2019.08.036.
20. Spencer EA, Jarchin L, Rolfes P, et al. Outcomes of primary ileocolic resection for pediatric Crohn‘s disease in the biologic era. J Pediatr Gastroenterol Nutr. 2021,73(6):710−716. doi: 10.1097/ MPG.0000000000003241. Epub ahead of print. PMID: 34292216.
21. Blackburn SC, Wiskin AE, Barnes C, et al. Surgery for children with Crohn‘s disease: indications, complications and outcome. Arch Dis Child. 2014 May;99(5):420−426. doi: 10.1136/archdischild- 2013-305214.
22. Hansen LF, Jakobsen C, Paerregaard A, et al. Surgery and postoperative recurrence in children with Crohn disease. J Pediatr Gastroenterol Nutr. 2015 Mar;60(3):347−351. doi: 10.1097/ MPG.0000000000000616.
23. Dotlacil V, Bronsky J, Hradsky O, et al. The impact of anti-tumor necrosis factor alpha therapy on postoperative complications in pediatric Crohn‘s disease. Eur J Pediatr Surg. 2020 Feb;30(1):27−32. doi: 10.1055/s-0039-1697909.
24. Lightner AL, McKenna NP, Alsughayer A, et al. Anti-TNF biologic therapy does not increase postoperative morbidity in pediatric Crohn’s patients. J Pediatr Surg. 2019;54(10):2162−2165. doi: 10.1016/j. jpedsurg.2019.01.006.
25. Abbas PI, Peterson ML, Fallon SC, et al. Evaluating the impact of infliximab use on surgical outcomes in pediatric Crohn’s disease. J Pediatr Surg. 2016 May;51(5):786−789. doi: 10.1016/j.jpedsurg.2016.02.023.
26. Zimmerman LA, Saites CG, Bairdain S, et al. Postoperative complications in children with Crohn disease treated with infliximab. J Pediatr Gastroenterol Nutr. 2016;63(03):352–356. doi: 10.1097/ MPG.0000000000001151.
27. Adamina M, Bonovas S, Raine T, et al. ECCO Guidelines on therapeutics in Crohn‘s disease: Surgical treatment. J Crohns Colitis. 2020 Feb 10;14(2):155−168. doi: 10.1093/ ecco-jcc/jjz187.
28. Pecere S, Petito V, Amatoet A, et al. Infliximab and tumor necrosis factor alpha measurement on intestinal mucosa: A new tool for the clinic? EMJ Gastroenterol. 2016;5[1]:107−115
Labels
Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2022 Issue 2
Most read in this issue
- Conservative versus surgical treatment of displaced midshaft clavicle fracture in adolescents
- Retrospective analysis of necrotizing pneumonia in children between 2015–2019
- Initial experience with single incision laparoscopic appendectomy
- Robotic pyeloplasty in children – a pilot study