Ulcerative Colitis Clinical Trial
Official title:
Preoperative Use of ANTI-Tumor Necrosis Factor Therapy in Ulcerative Colitis Patients Who Underwent Ileal Pouch-Anal Anastomosis (IPAA) is Not Associated With Histological Fibrosis
BACKGROUND: Previous studies of short-term surgical outcomes after preoperative exposure to
anti-TNF therapy in ulcerative colitis (UC) patients who have undergone IPAA have been
conflicting. We sought to determine whether preoperative exposure to anti-TNF therapy affects
histological measures of fibrosis in the colorectum, which may be a potential factor in
adverse anastomosis complications following IPAA surgery.
METHODS: Individuals who received infliximab as maintenance therapy and who received their
last dose within 180 days of the first stage of IPAA were selected. The control group
comprised UC patients who were not exposed to anti-TNF therapy, matched by age, sex, BMI,
disease duration, albumin levels, and post-operative leak outcome. Hematoxylin and eosin-
(H&E) and trichrome-stained slides from the most distal, well-oriented, full-thickness
section of colorectum from each patient's total colectomy specimen were evaluated. Blinded
assessment of the degree of fibrosis in the lamina propria, the submucosa, the submucosa
immediately adjacent to the muscularis propria, and the subserosa was performed by a single
observer using a semi-quantitative pictorial scale.
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