Safety of bariatric surgery in patients with inflammatory bowel disease: A systematic review and meta-analysis.
Muhammad AzizHossein HaghbinSachit SharmaRawish FatimaRizwan IshtiaqSaurabh ChandanBabu P MohanWade Lee-SmithMona HassanAli NawrasPublished in: Clinical obesity (2020)
The efficacy of bariatric surgery in achieving weight loss and preventing long-term comorbidities such as cardiovascular diseases, diabetes mellitus and osteoarthritis is well established. Data regarding safety of bariatric surgery in patients with inflammatory bowel disease (IBD) is scarce. We attempted a systematic review and meta-analysis to evaluate the complications following bariatric surgery in patients with IBD. The primary outcomes evaluated were wound infection, Clavien-Dindo grade > II complications and IBD exacerbation (within 1 year). Secondary outcomes evaluated included overall mortality, stricture, small bowel obstruction, acute kidney injury (AKI) and thromboembolism. Pooled outcomes (event rate) with 95% confidence interval (CI) were calculated using random effects model. A total of 14 studies (all observational) with 2608 patients were included. The rates of primary outcomes were: wound infection (4.1%, 95% CI: 0.9-7.2), Clavien-Dindo grade > II complications (2.0%, 95%: CI 0.6-3.5) and IBD exacerbation (4.3%, 95% CI: 0.7-7.9). The pooled rate for other outcomes was: mortality 0.1%, stricture 6.5%, small bowel obstruction 6.7%, AKI 2.2% and thromboembolism 0.1%. Bariatric surgery is relatively safe in patients with IBD and should be pursued to reduce comorbidities associated with obesity. Future comparative studies are needed to further assess the safety of bariatric surgery in population with and without IBD.
Keyphrases
- bariatric surgery
- weight loss
- obese patients
- acute kidney injury
- small bowel
- patients with inflammatory bowel disease
- glycemic control
- risk factors
- roux en y gastric bypass
- gastric bypass
- cardiovascular disease
- chronic obstructive pulmonary disease
- chronic kidney disease
- end stage renal disease
- ulcerative colitis
- type diabetes
- cardiac surgery
- rheumatoid arthritis
- weight gain
- newly diagnosed
- ejection fraction
- clinical trial
- electronic health record
- randomized controlled trial
- knee osteoarthritis
- body mass index
- artificial intelligence
- wound healing
- case control
- physical activity
- phase iii
- cardiovascular risk factors
- double blind
- surgical site infection