(TKP2021-EGA-23) Funder: Ministry for Innovation and Technology
Subjects:
Paediatrics
Biological agents have transformed the management of inflammatory bowel disease (IBD).
However, intestinal resection is still unavoidable in complicated IBD. It is still
under debate whether antitumor necrosis factor (TNF)-α is related to higher postoperative
complications in children with IBD. Therefore, we aimed to analyze data on preoperative
anti-TNF-α and postoperative complications in pediatric IBD.We conducted a systematic
literature search in 4 databases for studies that compared the incidence of postoperative
complications between children with IBD who received anti-TNF-α treatment within 12
weeks prior to intestinal resection and who did not receive anti-TNF-α before the
operation. To analyze this question, pooled odds ratios (ORs) were calculated with
95% confidence intervals (CIs). Odds ratios higher than 1 mean higher complication
rate among children treated with preoperative anti-TNF-α, whereas an OR lower than
1 means lower complication rate. The I² value was calculated to measure the strength
of the between-study heterogeneity, where a smaller percentage means the lower heterogeneity.We
found 8 eligible articles with 526 pediatric patients with IBD. The primary outcome
was the overall complication. The pooled OR of overall complications was 1.38 (95%
CI, 0.10-18.76; P = .65; I2 = 34%) in contrast, the OR of infectious and noninfectious
complications were 0.59 (95% CI, 0.21-1.69; P = .16; I2 = 0%) and 0.48 (95% CI, 0.18-1.25;
p = .09; I2 = 0%), although both showed a nonsignificant result.There is no significant
association between preoperative anti-TNF-α therapy and postoperative complications
in children with IBD after intestinal resection. However, the evidence is low due
to the low number of studies investigating this question.
