Surgery in (pre)malignant celiac disease

Table 1 Baseline characteristics, indication and operative procedure n (%)

Characteristics	Total	Acute setting	Elective setting	P value
	n = 40	n = 15	n = 25
Gender M/F	23/17	7/8	16/9	0.28
	(57/43)	(47/53)	(64/36)
Mean age (yr) at resection (mean ± SD, range)	(62 ± 7, 48-77)	(61 ± 6, 48-70)	(63 ± 7, 49-77)	0.25
Diagnosis				0.08
EATL	35 (88)	15 (100)	20 (80)
UJ	5 (12)		5 (20)
Indication				< 0.001
Perforation	12 (30)	10 (67)	2 (8)
Stenosis	13 (32)	4 (27)	9 (36)
Local resection	11 (28)		11 (44)
Other	4 (10)	1 (6)	3 (12)
Procedure				0.25
Open	34 (85)	14 (93)	20 (80)
Laparoscopic	6 (15)	1 (7)	5 (20)
Conversion (n)	n = 3	n = 1	n = 2	0.69
Resected				0.59
Jejunum	27 (67)	9 (60)	18 (72)
Jejunum and Ileum	7 (18)	3 (20)	4 (16)
Ileum	4 (10)	2 (13)	2 (8)
Other	2 (5)	1 (7)	1 (4)
Median length of resected segment (cm) (range)	35 (9-155)	20 (10-50)	40 (9-155)	0.07
Resectability				0.55
Radical resection	28 (70)	10 (67)	18 (72)
Partial resection	9 (23)	3 (20)	6 (24)
Unresectable	3 (7)	2 (13)	1 (4)

EATL: Enteropathy associated T-cell lymphoma; UJ: Ulcerative jejunitis.

Table 2 Early and late postoperative morbidity and mortality n (%)

	Total	Acute setting	Elective setting	P value
	n = 40	n = 15	n = 25
ICU-stay (n)	10	5	5	1.0
Median days (range)	9 (1-37)	15 (1-37)	6 (1-28)	0.31
Median hospital stay (d) (range)	10 (2-63)	10 (2-48)	11 (4-63)	1.0
Median follow-up after surgery (mo) (range)	14 (0.5-125)	6 (0.5-125)	16 (1-100)	0.09
Early complications	14 (35)	7 (40)	7 (28)	0.65
Anastomotic leakage	n = 5	n = 3	n = 2
Fever/sepsis	n = 4	n = 3
Bleeding	n = 2		n = 2
Ileus	n = 1		n = 1
Cardiac failure	n = 1	n = 1
Wound dehiscence	n = 1		n = 1
Reoperation necessary	8 (20)	3 (20)	5 (21)	0.44
Late complications,	5 (13)	0 (0)	5 (20)	0.08
Stenosis/ileus	n = 4		n = 4
Anastomotic leakage after	n = 1		n = 1
stoma reconstruction
Median time after initial surgery (mo)	N.E.		58
Post-operative mortality	3 (8)	3 (20)	0 (0)	0.02
In-hospital mortality	5 (13)	3 (20)	2 (8)	0.23

N.E.: Could not be estimated.

Table 3 Postoperative therapy and overall survival n (%)

	Total	Acute setting	Elective setting	P value
	n = 40	n = 15	n = 25
Treatment				0.04
Resection alone	12 (30)	8 (53)	4 (16)
Resection and chemotherapy	19 (47)	4 (27)	15 (60)
Resection, chemotherapy and SCT	9 (13)	3 (20)	6 (24)
Death	26 (65)	12 (80)	14 (56)	0.12
Overall survival (mo)	15	8	19	0.05
1-yr survival	57%	40%	67%
5-yr survival	29%	18%	34%

SCT: Stem-cell transplantation.