P371 Assessment Of Postoperative Complications Following Ileocecal Resection In Crohn’s Disease From A Low-To-Middle Income Country
Benammi, S.(1)*;Naddouri, J.(1);Bakkali, Y.(1);Alaoui, M.(1);Sebbah, F.(1);Raiss, M.(1);Hrora, A.(1);
(1)University Mohamed V, General Surgery C, Rabat, Morocco;
Background
Our study aims to assess risk factors of postoperative complications following ileocecal resection of Crohn’s disease from a low-to-middle income country perspective. We aimed to provide local data demonstrative of inner conditions and challenges.
Methods
This was a retrospective study conducted in a referral colorectal center in a low-to-middle income country from 2014 to 2020. We included all patients with Crohn’s disease admitted to our department for ileocecal resection. Patient’s and Crohn’s disease, surgical and postoperative characteristics were collected using chart review. We excluded all patients with missing data. We defined perioperative hemorrhage as blood loss≥200cc. Our primary outcome was immediate<90-days post-operative complications risk factors assessment.
Results
We included 83 patients with complete data. The median age was 34(18-75) and 54.2%(n=45) were female. Patients were 94.6%from urban areas and 5.4%(n=4) rural. Among all included surgeries, 83.1%(n=69) were elective and 16.9%(n=14) were emergency cases. Open surgery was conducted in 46 cases(55.4%), 30patients had laparoscopic ileocecal resection (36.1%), and 7(8.4%) had conversion. Immediate postoperative complications were reported in 16.9%(n=14);anastomotic leak 2(2.4%), surgical site infection 8(9.6%), entero-cutaneous fistula 2(2.4%), and postoperative hemorrhage 2(2.4%). Long-term outcomes with surgical reoperation were conducted in 5 cases(5.8%) excluding stoma removal. The total length of stay median was 6 days (4-31). Immediate postoperative complications were associated with postoperative bleeding(OR=27.8; 95% CI[1.26-614];p=0.001,Fisher’s=0.027), required transfusion during surgery or at postoperative follow-up(OR=18.3;95% CI[3.09-109];p<0.001,Fisher’s=0.001), hospital length of stay(t-test<0.001), pre-operative hemoglobin(t-test0.031).
Conclusion
Considering the accessibility of hemoglobin management in a low-to-middle income country, it represents an impactful tool in surgical quality enhancement.