Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Arch Med Sci. 2011 Dec 31;7(6):1000-12. doi: 10.5114/aoms.2011.26612. Epub 2011 Dec 30.
Use of biological therapies may reduce or delay the surgical procedures in patients with inflammatory bowel disease (IBD). The aim of this meta-analysis and systematic review was to determine the impact of pre-operative infliximab (IFX) use on the rate of surgical interventions in patients with IBD and also the effect of preoperative IFX therapy on post-surgical complications.
Literature was searched for studies that investigated the efficacy of IFX on the rate of colectomy and post-operative complications/side effects in patients with IBD between 1966 and February 2011.
Twelve articles were included in the meta-analysis. In comparison to control groups, patients who received IFX had a relative risk (RR) of 1.17 (p = 0.65) for the rate of colectomy, odds ratio of 3.34 (p = 0.09) in seven observational studies and RR of 0.74 (p = 0.79) in clinical trials for mortality. Summary RR of hospitalization was 0.61 (p = 0.005). Infections and anastomotic leak, pouch-related complications, sepsis and thrombotic events were more common in the patients under IFX therapy but post-operational hospitalization was lower. The patients with IBD who were under IFX therapy were most of the times refractive to other therapies and their disease was more severe.
Although IFX does not decrease the rate of colectomy in patients with IBD, it would not increase most of the post-operational side effects in the patients.
生物疗法的应用可以减少或延迟炎症性肠病（IBD）患者的手术程序。本荟萃分析和系统评价的目的是确定术前使用英夫利昔单抗（IFX）对 IBD 患者手术干预率的影响，以及术前 IFX 治疗对术后并发症的影响。
检索了 1966 年至 2011 年 2 月期间研究 IFX 对 IBD 患者结肠切除术和术后并发症/副作用发生率影响的文献。
共有 12 篇文章纳入荟萃分析。与对照组相比，接受 IFX 治疗的患者结肠切除术的相对风险（RR）为 1.17（p=0.65），7 项观察性研究的优势比（OR）为 3.34（p=0.09），临床试验的 RR 为 0.74（p=0.79）。住院的汇总 RR 为 0.61（p=0.005）。感染和吻合口漏、袋相关并发症、败血症和血栓事件在接受 IFX 治疗的患者中更为常见，但术后住院率较低。接受 IFX 治疗的 IBD 患者通常对其他治疗方法有抗性，并且他们的疾病更为严重。
虽然 IFX 不能降低 IBD 患者的结肠切除术率，但它不会增加大多数术后的副作用。
