National variations in perioperative assessment and surgical management of Crohn’s disease: a multicentre study

Claudio Coco, Gianluca Rizzo, Francesco Sionne, Valerio Celentano, Gianluca Pellino, Matteo Rottoli, Gilberto Poggioli, Giuseppe Sica, Mariano Cesare Giglio, Michela Campanelli, Francesco Colombo, Gianluca Sampietro, Giulia Lamperti, Diego Foschi, Ferdinando Ficari, Ludovica Vacca, Marta Cricchio, Francesco Giudici, Lucio Selvaggi, Guido SciaudoneRoberto Peltrini, Andrea Manfreda, Luigi Bucci, Raffaele Galleano, Omar Ghazouani, Luigi Zorcolo, Simona Deidda, Angelo Restivo, Andrea Braini, Francesca Di Candido, Matteo Sacchi, Michele Carvello, Stefania Martorana, Giovanni Bordignon, Imerio Angriman, Angela Variola, Mirko Di Ruscio, Giuliano Barugola, Andrea Geccherle, Francesca Paola Tropeano, Gaetano Luglio, Marta Tanzanu, Diego Sasia, Marco Migliore, Maria Carmela Giuffrida, Enrico Marrano, Gianluigi Moretto, Harmony Impellizzeri, Gaetano Gallo, Giuseppina Vescio, Giuseppe Sammarco, Giovanni Terrosu, Giacomo Calini, Andrea Bondurri, Anna Maffioli, Gloria Zaffaroni, Andrea Resegotti, Massimiliano Mistrangelo, Marco Ettore Allaix, Fiorenzo Botti, Matteo Prati, Luigi Boni, Serena Perotti, Michela Mineccia, Lucia Romano, Giorgio Maria Paolo Graziano, Luigi Pugliese, Andrea Pietrabissa, Giangaetano Delaini, Antonino Spinelli, Francesco Selvaggi

Risultato della ricerca: Contributo in rivistaArticolo in rivista

6 Citazioni (Scopus)

Abstract

Aim: Crohn's disease (CD) requires a multidisciplinary approach and surgery should be undertaken by dedicated colorectal surgeons with audited outcomes. We present a national, multicentre study, with the aim to collect benchmark data on key performance indicators in CD surgery, to highlight areas where standards of CD surgery excel and to facilitate targeted quality improvement where indicated. Methods: All patients undergoing ileocaecal or redo ileocolic resection in the participating centres for primary and recurrent CD from June 2018 to May 2019 were included. The main objective was to collect national data on hospital volume and practice variations. Postoperative morbidity was the primary outcome. Laparoscopic surgery and stoma rate were the secondary outcomes. Results: In all, 715 patients were included: 457 primary CD and 258 recurrent CD with a postoperative morbidity of 21.6% and 34.7%, respectively. Laparoscopy was used in 83.8% of primary CD compared to 31% of recurrent CD. Twenty-five hospitals participated and the total number of patients per hospital ranged from 2 to 169. Hospitals performing more than 10 primary CD procedures per year showed a higher adoption of laparoscopy and bowel sparing surgery. Conclusions: There is significant heterogeneity in the number of CD surgeries performed per year nationally in Italy. Our data suggest that high-volume hospitals perform more complex procedures, with a higher adoption of bowel sparing surgery. The rate of laparoscopy in high-volume hospitals is higher for primary CD but not for recurrent CD compared with low-volume hospitals.
Lingua originaleEnglish
pagine (da-a)94-104
Numero di pagine11
RivistaColorectal Disease
Volume23
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • Crohn's disease
  • colorectal surgery
  • ileocaecal resection
  • inflammatory bowel disease
  • national audit

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