Initial Management of Intra-abdominal Abscesses and Preventive Strategies for Abscess Recurrence in Penetrating Crohn's Disease: A National, Multicentre Study Based on ENEIDA Registry.

التفاصيل البيبلوغرافية
العنوان:	Initial Management of Intra-abdominal Abscesses and Preventive Strategies for Abscess Recurrence in Penetrating Crohn's Disease: A National, Multicentre Study Based on ENEIDA Registry.
المؤلفون:	Casas Deza D; Gastroenterology Department, University Hospital Miguel Servet, Zaragoza, Spain.; Institute for Health Research Aragón [IIS Aragón], Zaragoza, Spain., Polo Cuadro C; Gastroenterology Department, University Hospital Miguel Servet, Zaragoza, Spain., de Francisco R; Gastroenterology Department, University Hospital Central de Asturias, and Instituto de Investigación Sanitaria del Principado de Asturias [ISPA], Oviedo, Spain., Vela González M; Gastroenterology Department, University Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain., Bermejo F; Gastroenterology Department, University Hospital of Fuenlabrada, Fuenlabrada, Spain., Blanco I; Gastroenterology Department, University Hospital Clínico San Carlos, Madrid, Spain., de la Serna Á; Gastroenterology Department, University Hospital Ramón y Cajal, Madrid, Spain., Bujanda L; Gastroenterology Department, University Hospital of Donostia, San Sebastian, Spain; Instituto Biodonostia, Universidad del País Vasco [UPV/EHU], CIBERehd, Spain., Bernal L; Gastroenterology Department, Hospital General de Alicante, Alicante, Spain., Rueda García JL; Gastroenterology Department, La Paz University Hospital. School of Medicine; Universidad Autónoma de Madrid. Hospital La Paz Institute for Health Research, La Paz Hospital, Madrid, Spain., Gargallo-Puyuelo CJ; Gastroenterology Department, University Hospital Lozano Blesa, Zaragoza, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBEREHD], Spain.; Institute for Health Research Aragón [IIS Aragón], Zaragoza, Spain., Fuentes-Valenzuela E; Gastroenterology Department, University Hospital Rio Hortega, Valladolid, Spain., Castro B; Gastroenteroly Department, University Hospital Marqués de Valdecilla, Santander, Spain., Guardiola J; Gastroenterology Department, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Spain., Ladrón G; Gastroenterology Department, University Hospital General de Castelló, Castellón, Spain., Suria C; Gastroenterology Department, University Hospital Clínico de Valencia, Valencia, Spain., Sáez Fuster J; Gastroenterology Department, University Hospital General de Elche, Spain., Gisbert JP; Gastroenterology Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa [IIS-Princesa], Universidad Autónoma de Madrid [UAM], Madrid, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBEREHD], Spain., Sicilia B; Gastroenterology Department, Hospital Universitario de Burgos, Burgos, Spain., Gomez R; Gastroenterology Department, University Hospital Fundación de Alcorcón, Alcorcón, Spain., Muñoz Vilafranca C; Gastroenterology Department, Basurto University Hospital, Bilbao, Spain., Barreiro-De Acosta M; Gastroenterology Department, Hospital Universitario de Santiago, Santiago de Compostela, Spain., Peña E; Gastroenterology Department, Hospital Royo Villanova, Zaragoza, Spain., Castillo Pradillo M; Gastroenterology Department, University Hospital Infanta Leonor, Madrid, Spain., Cerrillo E; Gastroenterology Department, University Hospital La Fe, Valencia, Spain., Calvet X; Gastroenterology Department, University Hospital Parc Taulí, Sabadel, Spain and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBEREHD], Spain., Manceñido N; Gastroenterology Department, University Hospital Infanta Sofía, San Sebastián de los Reyes, Spain., Monfort I Miquel D; Gastroenterology Department, Consorci Sanitari de Terrassa, Terrasa, Spain., Marín S; Gastroenterology Department, University Hospital Reina Sofía, Córdoba, Spain., Roig C; Gastroenterology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain., Marce A; Gastroenterology Department, Hospital Moisès Broggi, Sant Joan Despí, Spain., Ramírez de Piscina P; Gastroenterology Department, Alava University Hospital, Alava, Spain., Betoré E; Gastroenterology Department, Hospital Universitario San Jorge, Huesca, Spain., Martin-Cardona A; Gastroenterology Department, Hospital Universitari Mútua Terrassa, Spain.; University of Barcelona, Terrassa, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBERehd], Spain., Teller M; Gastroenterology Department, Althaia Xarxa Assistencial Universitaria de Manresa, Manresa, Spain., Alonso Abreu I; Gastroenterology Department, Hospital Universitario de Canarias, Tenerife, Spain., Maroto N; Gastroenterology Department, Hospital de Manises, Manises, Spain., Frago S; Gastroenterology Department, Hospital Santa Bárbara, Soria, España., Gardeazabal D; Gastroenterology Department, Biocruces Bizkaia HRI, Galdakao, Spain., Pérez-Martínez I; Gastroenterology Department, University Hospital Central de Asturias, and Instituto de Investigación Sanitaria del Principado de Asturias [ISPA], Oviedo, Spain., Febles González ÁD; Gastroenterology Department, University Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain., Barrero S; Gastroenterology Department, University Hospital of Fuenlabrada, Fuenlabrada, Spain., Taxonera C; Gastroenterology Department, University Hospital Clínico San Carlos, Madrid, Spain., García de la Filia I; Gastroenterology Department, University Hospital Ramón y Cajal, Madrid, Spain., Ezkurra-Altuna A; Gastroenterology Department, University Hospital of Donostia, San Sebastian, Spain; Instituto Biodonostia, Universidad del País Vasco [UPV/EHU], CIBERehd, Spain., Madero L; Gastroenterology Department, Hospital General de Alicante, Alicante, Spain., Martín-Arranz MD; Gastroenterology Department, La Paz University Hospital. School of Medicine; Universidad Autónoma de Madrid. Hospital La Paz Institute for Health Research, La Paz Hospital, Madrid, Spain., Gomollón F; Gastroenterology Department, University Hospital Lozano Blesa, Zaragoza, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBEREHD], Spain.; Institute for Health Research Aragón [IIS Aragón], Zaragoza, Spain., Domènech E; Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBEREHD], Spain.; Universitat Autònoma de Barcelona, Spain., García-López S; Gastroenterology Department, University Hospital Miguel Servet, Zaragoza, Spain.; Institute for Health Research Aragón [IIS Aragón], Zaragoza, Spain.
المصدر:	Journal of Crohn's & colitis [J Crohns Colitis] 2024 Apr 23; Vol. 18 (4), pp. 578-588.
نوع المنشور:	Journal Article; Multicenter Study
اللغة:	English
بيانات الدورية:	Publisher: Oxford University Press Country of Publication: England NLM ID: 101318676 Publication Model: Print Cited Medium: Internet ISSN: 1876-4479 (Electronic) Linking ISSN: 18739946 NLM ISO Abbreviation: J Crohns Colitis Subsets: MEDLINE
أسماء مطبوعة:	Publication: 2015- : Oxford : Oxford University Press Original Publication: Amsterdam : Elsevier Science
مواضيع طبية MeSH:	Crohn Disease/complications , Abdominal Abscess/etiology , Abdominal Abscess/prevention & control , Abdominal Abscess/therapy , Drainage/methods , Registries , Anti-Bacterial Agents/therapeutic use , Recurrence, Humans ; Male ; Female ; Adult ; Spain ; Middle Aged ; Secondary Prevention/methods
مستخلص:	Introduction: Intra-abdominal abscesses complicating Crohn's disease [CD] are a challenging situation. Their management, during hospitalisation and after resolution, is still unclear. Methods: Adult patients with CD complicated with intra-abdominal abscess. who required hospitalisation, were included from the prospectively maintained ENEIDA registry from GETECCU. Initial strategy effectiveness and safety to resolve abscess was assessed. Survival analysis was performed to evaluate recurrence risk. Predictive factors associated with resolution were evaluated by multivariate regression and predictive factors associated with recurrence were assessed by Cox regression. Results: In all, 520 patients from 37 Spanish hospitals were included; 322 [63%] were initially treated with antibiotics alone, 128 [26%] with percutaneous drainage, and 54 [17%] with surgical drainage. The size of the abscess was critical to the effectiveness of each treatment. In abscesses < 30 mm, the antibiotic was as effective as percutaneous or surgical drainage. However, in larger abscesses, percutaneous or surgical drainage was superior. In abscesses > 50 mm, surgery was superior to percutaneous drainage, although it was associated with a higher complication rate. After abscess resolution, luminal resection was associated with a lower 1-year abscess recurrence risk [HR 0.43, 95% CI 0.24-0.76]. However, those patients who initiated anti-TNF therapy had a similar recurrence risk whether luminal resection had been performed. Conclusions: Small abscesses [<30mm] can be managed with antibiotics alone; larger ones require drainage. Percutaneous drainage will be effective and safer than surgery in many cases. After discharge, anti-TNF therapy reduces abscess recurrence risk in a similar way to bowel resection. (© The Author(s) 2023. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
معلومات مُعتمدة:	CM21/00067 Instituto de Salud Carlos III
فهرسة مساهمة:	Keywords: Crohn’s disease; anti-TNF; intra-abdominal abscess
المشرفين على المادة:	0 (Anti-Bacterial Agents)
تواريخ الأحداث:	Date Created: 20231106 Date Completed: 20240423 Latest Revision: 20240423
رمز التحديث:	20240424
DOI:	10.1093/ecco-jcc/jjad184
PMID:	37930823
قاعدة البيانات:	MEDLINE

الوصف
تدمد:	1876-4479
DOI:	10.1093/ecco-jcc/jjad184