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Session: ePoster Monitor 5-IBD 3

eP734 - Clinical and Enhanced Recovery After Surgery Outcomes in Ileocecal Resection for Crohn’s Disease versus Right Hemicolectomy for Colon Cancer

Tuesday, June 4, 2024
8:06 AM – 8:11 AM ET, USA
Location: Baltimore Convention Center, Room 318-320

    Author(s)

  • Mohammed AM AL-Abri, MD

    Resident doctor
    General Surgery residency program at the University of British Columbia
    University of British Columbia
    Vancouver, BC, Canada

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • ePoster Presenter(s)

  • Elliott K.W Gee (he/him/his)

    Medical Student
    University of British Columbia
    Vancouver, BC, Canada

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • MR

    Manoj Raval, MD, MSc, FRCSC

    Colorectal Surgeon
    St. Paul's Hospital, University of British Columbia
    Vancouver, British Columbia, Canada

    Disclosure information not submitted.

  • Carl Brown, MD

    Professor
    St. Paul's Hospital, University of British Columbia
    University of British Columbia
    Vancouver, BC, Canada

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no relevant relationships with ineligible companies.

  • PP

    P. Terry Phang, MD

    MD
    UBC
    Vancouver, British Columbia, Canada

    Disclosure information not submitted.

  • AK

    Ahmer Karimuddin, MD, FRCSC

    Associate Professor
    University of British Columbia
    Vancouver, British Columbia, Canada

    Disclosure information not submitted.

    • Senior Author(s)

  • AG

    Amandeep (Anu) Ghuman, MD, MPH, FRCSC

    Clinical assistant professor
    University of British Columbia
    Vancouver, British Columbia, Canada

    Disclosure information not submitted.

Purpose/Background: Enhanced recovery after surgery (ERAS) protocols for colorectal surgery have led to significant improvement in patient outcomes, including fewer postoperative complications and shorter length of hospital stay (LOS). While the ERAS protocols have been primarily studied on colorectal cancer patients, few studies have focused on inflammatory bowel diseases (IBD). We compared ERAS complications and outcomes in ileocecal resection for Crohn's disease versus right hemicolectomy for right sided colon cancer (CC) to understand the impact of ERAS protocols between these two conditions.Methods/Interventions: Retrospective cohort study conducted with all elective patients in the National Surgical Quality Improvement Program (NSQIP) database undergoing ileocecal resection for CD or right hemicolectomy for CC between January 1, 2016 to December 31, 2020. Emergency operations or additional colonic resections were excluded. ERAS outcomes compared between CD and CC patients included postoperative complications, LOS, 30-day readmission rate, and 30-day reoperation rate.Results/Outcomes: A total of 41,849 patients were included in our cohort: 10,813 with CD (25.8% of cohort) and 31,036 with CC (74.2% of cohort). We compared incidence of complications and found that superficial surgical site infection was significantly higher in Crohn’s disease, occurring in 3.2% versus 2.4% (p < 0.001). We found statistically significant lower incidences of pulmonary embolism (p < 0.001), incidence of pneumonia (p < 0.001), and incidence of urinary tract infections (p < 0.007) in the Crohn’s disease cohort. We also found LOS in hospital (p=0.004) and 30-day readmission rate (p < 0.001) was statistically significantly higher in Crohn’s disease patients, although LOS was not clinically significantly different (6.3 vs 5.9 days).Conclusion/

Discussion: Within our findings, Crohn's disease patients had a significantly increased readmission rate within 30 days of discharge. This might bear important implications in patient care, hospital resources allocation, and may signify the complexity of patients with inflammatory bowel diseases. The significantly higher rate of superficial surgical site infection in the CD group may highlight the need for more curated surgical site management. Conversely, the lower rates of pulmonary embolism, pneumonia, and urinary tract infection in CD patients can be attributed to the fact that this group is significantly younger than the CC group. In conclusion, our findings necessitate the need for inflammatory bowel disease specific ERAS protocol to improve patient outcomes in this population and may allow for better healthcare resource allocation.Table 1. Demographics and ResultsThis table display a summary of the demographics of the study's patient population as well as the results with the P value