TABLE 2.
Perioperative patient characteristics
| Variable | n = 22 |
|---|---|
| Baseline characteristics | |
| Age | 31.5 (23.75–40.25) |
| BMI, kg/m2 | 24.5 (21.4–26.0) |
| Female, n (%) | 9 (40) |
| Indications, n (%) | |
| Stricture (including 4 anastomotic strictures) | 22 (100) |
| Fistula | 13 (59) |
| Montreal classification, n (%) | |
| A2: 17–40 y | 16 (72) |
| A3: >40 y | 6 (27) |
| L1: ileal | 19 (86.4) |
| L3: ileocolonic | 2 (9.1) |
| L1/L2: ileal and colonic | 1 (4.5) |
| B1: nonpenetrating, nonstricturing | nil |
| B2: structuring | 9 (40) |
| B2/B3: stricturing + penetrating | 13 (59) |
| p: perianal disease | 5 (23) |
| Preoperative therapy, n (%) | |
| Corticosteroids | 12 (54) |
| Weaned off preoperatively | 11 (92) |
| Budesonide | 3 (14) |
| Antibiotics | 7 (31) |
| Immunomodulators (thioguanines or methotrexate) | nil |
| Biologics | 18 (81) |
| TNFi | 6 (27) |
| Ustekinumab | 7 (31) |
| Vedolizumab | 5 (23) |
| Interventional | 9 (41)a |
| Endoscopic balloon dilation | 6 (27) |
| Percutaneous drain | 4 (18) |
| Nutritional | 6 (27) |
| Exclusive enteral nutrition | 4 (18) |
| Total parenteral nutrition | 2 (9) |
| Operative techniques, n (%) | |
| Redo ileocolic resection | 6 (27) |
| Extensive adhesiolysis | 8 (36) |
| Laparoscopic, attempted | 16 (72) |
| Laparoscopy converted | 5 (31) |
| Laparotomy (open) | 6 (27) |
| Laparoscopic, completed | 11 (50) |
| Length of incision, cm | 5.25 (3.9–15.25) |
| Mode | p = 0.0002 |
| Lap-completed, cm | 4 (3.5–4) |
| Lap-converted, cm | 10 (8–16.5) |
| Laparotomy (open), cm | 20 (14.5–22.5) |
| Mesenteric defect closed, n (%) | 19 (86) |
| Omental flap, n (%) | 17 (77) |
| Diverting loop ileostomy, n (%) | 3 (14) |
| Length of bowel | |
| Small bowel, operative note, cm | 22.5 (13.8–30) |
| Small bowel, gross pathology, cm | 21 (11–31.5) |
| Small bowel remaining in situ, cm (missing in 4) | 400 (350–432.5) |
| Colon, gross pathology, cm | 8 (6.7–12.8) |
| Perioperative outcomes | |
| Operative time, min | 174.5 (149.8–236) |
| Estimated blood loss, mL | 87.5 (50–150) |
| Blood transfusions | nil |
| Ileus, n (%) | 2 (9) |
| Length of stay, days | 4 (3–5) |
| Readmission, n (%) | 2 (9)b |
| Reoperation (EUA, seton), n (%) | 1 (4.5) |
| Intra-abdominal septic complication | nil |
| Surgical site infections (superficial), n (%) | 1 (4.5) |
| Anastomotic leaks | nil |
| Postoperative medical therapy, n (%) | |
| Biologicc | 18 (81) |
| TNFi (1 combined with methotrexate) | 7 (31.5) |
| Ustekinumab | 8 (36) |
| Vedolizumab | 3 (13) |
| None | 4 (18) |
| Corticosteroids/antibiotics/TPN | nil |
Figures represent frequency (proportion) or median (interquartile range); p value represents Wilcoxon rank-sum test (length of incision by mode).
EBD = endoscopic balloon dilation; EUA = examination under anesthetic; TNFi = tumor necrosis factor inhibitor; TPN = total parenteral nutrition.
a
One patient had both EBD and percutaneous drainage.
b
One for EUA, seton; 1 for percutaneous drainage of sterile fluid collection.
c
Of the 18 patients on preoperative biologics, 13 continued, 3 were discontinued, and 2 were class switched; 3 biologic-naive patients started a biologic postoperatively.