Zanelli Jasmine, Chandrapalan Subashini, Patel Abhilasha, Arasaradnam Ramesh P
Warwick Medical School, University of Warwick, Coventry, UK.
Oxford University Hospitals Foundation NHS Trust, Oxford, UK.
Therap Adv Gastroenterol. 2020 Aug 18;13:1756284820937089. doi: 10.1177/1756284820937089. eCollection 2020.
Biologic therapy has emerged as an effective modality amongst the medical treatment options available for ulcerative colitis (UC). However, its impact on post-operative care in patients with UC is still debatable. This review evaluates the risk of post-operative complications following biologic treatment in patients with UC.
A systematic search of the relevant databases was conducted with the aim of identifying studies that compared the post-operative complication rates of UC patients who were either exposed or not exposed to a biologic therapy prior to their surgery. Outcomes of interest included both infection-related complications and overall surgical morbidity. Pooled odds-ratio (OR) and 95% confidence intervals (CI) were calculated using Review Manager 5.3.
In all, 20 studies, reviewing a total of 12,494 patients with UC, were included in the meta-analysis. Of these, 2254 patients were exposed to a biologic therapy prior to surgery. The pooled ORs for infection-related complications ( = 8067) and overall complications ( = 11,869) were 0.98 (95% CI 0.66-1.45) and 1.14 (95% CI 1.04-1.28), respectively, which suggested that there was no significant association between the use of pre-operative biologic therapy and post-operative complications. Interestingly, the interval between the last dose of biologic therapy and surgery did not influence the risk of having a post-operative infection.
This meta-analysis suggests that pre-operative biologic therapy does not increase the overall risk of having post-operative infection-related or other complications.
生物疗法已成为溃疡性结肠炎（UC）现有医疗选择中的一种有效治疗方式。然而，其对UC患者术后护理的影响仍存在争议。本综述评估了UC患者接受生物治疗后发生术后并发症的风险。
对相关数据库进行系统检索，旨在识别比较术前接受或未接受生物治疗的UC患者术后并发症发生率的研究。感兴趣的结果包括感染相关并发症和总体手术发病率。使用Review Manager 5.3计算合并比值比（OR）和95%置信区间（CI）。
总共20项研究纳入了荟萃分析，共涉及12494例UC患者。其中，2254例患者在手术前接受了生物治疗。感染相关并发症（=8067）和总体并发症（=11869）的合并OR分别为0.98（95%CI 0.66-1.45）和1.14（95%CI 1.04-1.28），这表明术前使用生物治疗与术后并发症之间无显著关联。有趣的是，最后一剂生物治疗与手术之间的间隔时间并未影响术后感染风险。
这项荟萃分析表明，术前生物治疗不会增加术后感染相关或其他并发症的总体风险。
