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Does Tacrolimus Affect the Outcome After Surgery for Ulcerative Colitis? Munenori Nagao*1, Kazuhiro Watanabe1, Hideaki Karasawa1, Tomoya Abe1, Shinobu Ohnuma1, Hiroaki Musha1, Chikashi Shibata2, Takeshi Naitoh1, Michiaki Unno1 1Department of Surgery, Tohoku University, Sendai, Miyagi, Japan; 2Department of Surgery, Tohoku Pharmaceutical University, Sendai, Japan
Background: Tacrolimus was approved as a medical treatment for intractable active ulcerative colitis (UC) since 2010 in Japan. As tacrolimus could induce clinical remission of active UC, patients undergoing treatment with tacrolimus are increasing. However, some patients require the surgical treatment due to ineffectiveness of various medical treatments including tacrolimus. It is unclear whether tacrolimus affects the postoperative outcome. Aim: The aim was to clarify whether preoperative tacrolimus increases postoperative complications in patients with UC. Methods: Medical records of the patients were reviewed retrospectively. There were 57 patients who underwent surgical treatment for UC, and these patients were classified into 2 groups; patients with preoperative tacrolimus (Group A, N=24) and without tacrolimus (Group B, N=33). Results: There were no differences in patients’ background between 2 groups in terms of age, severity and activity of the disease, location of inflammation, timing of operation (i.e. emergency or elected), and performed surgical procedure for UC. The incidence of surgical site infection did not differ between Group A (0%) and B (2/33, 6%) as well as remote organ infection such as postoperative pneumonia and catheter related blood stream infection (2/24, 8% in Group A and 2/33, 6% in Group B). Intestinal obstruction was observed in 8 patinets (33%) in Group A and 4 (12%) in Group B (P>0.05). The incidence of enteritis and proctitis of the remnant rectum in Group A (4% and 0%) was not different from that in Group B (3% and 9%). Overall morbidity rate was 58.3% (14/24) in Group A and 42.4% (14/33) in Group B (P>0.05). Conclusions: These results indicate that preoperative tacrolimus does not increase postoperative complications in the operation for UC. Back to 2016 Annual Meeting |
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