LAUSR

Dear Editor, We read with great interest the manuscript entitled “The Impact of Preoperative Anti-TNFα Therapy on Postoperative Outcomes Following Ileocolectomy in Crohn’s Disease” by Kulaylat et al., recently published in the Journal of Gastrointestinal Surgery. 1 In a retrospective study including 2364 patients submitted to ileocolonic resection (28.4% previously exposed to anti-TNF therapy), previous use of TNFalpha inhibitors was independently associated with increased rates of postoperative infectious complications. There was no association between timing of administration of these biologics and increased postoperative morbidity. The controversy over the precise impact of preoperative exposure to biologics in postoperative outcomes in Crohn’s disease (CD) is still a matter of debate in the field of colorectal surgery. Few prospective studies were published to date aiming to analyze this relationship. Lau et al. described that in 123 individuals submitted to abdominal operations in CD, patients with infliximab levels above 3ug/ml had an increase in rates of overall infectious complications (OR=2.5, p=0.03). 2