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Paulo Gustavo Kotze,Daniela Oliveira Magro,Barbara Saab,Mansur Paulo Saab,Lilian Vital Pinheiro,Marcia Olandoski,Maria de Lourdes Setsuko Ayrizono,Carlos Augusto Real Martinez,Claudio Saddy Rodrigues 대한장연구학회 2018 Intestinal Research Vol.16 No.1
Background/Aims: The use of anti-tumor necrosis factor (anti-TNF) agents seems to reduce surgical rates and delay surgicalprocedures in prospective trials and population-based studies in the management of Crohn’s disease (CD). This study aimedto identify whether preoperative anti-TNF agents influence the time from diagnosis to surgery. Methods: An observationalretrospective cohort study was conducted on patients with CD submitted to intestinal resections due to complications ormedical therapy failure in a period of 7 years. The patients were allocated into 2 groups according to their previous exposure toanti-TNF agents in the preoperative period. Epidemiological aspects regarding age at diagnosis, smoking, perianal disease, andpreoperative conventional therapy were considered. A Kaplan-Meier survival analysis was used to outline possible differencesbetween the groups regarding the time to surgery. Results: A total of 123 patients were included (71 and 52 with and withoutprevious exposure to biologics, respectively). The overall time to surgery was 108±6.9 months (maximum, 276 months). The survival estimation revealed no difference in the mean time to intestinal resection between the groups (99.78±10.62 months inthe patients without and 114.01±9.07 months in those with previous anti-TNF use) (log-rank P =0.35). There was no significantdifference in the time to surgery regarding perianal CD (P =0.49), smoking (P =0.63), preoperative azathioprine (P =0.073) andsteroid use (P =0.58). Conclusions: The time from diagnosis to surgery was not influenced by the preoperative use of anti-TNFtherapy in this cohort of patients.