The impact of ustekinumab (UST) therapy on surgical complications in patients with Crohn’s disease (CD) remains controversial. The aim of this meta-analysis is to explore the link between these two.
Databases (PubMed, Web of Science, Cochrane, and Springer Link) were searched until April 2022. Studies of CD patients who received UST and no UST prior to surgery (including no biological therapy, anti-TNF-α agent, and VDZ) were included. Primary outcomes included overall complications, infectious complications, and non-infectious complications.
Nine studies totaling 3,225 CD patients were enrolled; 332 patients received UST treatment. There was no evidence of difference in the overall complications (OR=0.84, p=0.37, 95%CI=[0.57-1.23], I2=40%) between CD patients who had UST treatment preoperatively and those who had no UST treatment. There was no evidence of a difference in infectious complications (OR=1.15, p=0.35, 95%CI=[0.86-1.53], I2=2%). Additionally, there was no significant no evidence of difference between these group in terms of non-infectious complications and death. Specifically, there were no evidence of difference in overall complications, infection complications (including wound complications, sepsis, abscess and anastomotic leakage), and non-infection complications (ileus, readmission, and return to operation), compared with no biological therapy and anti-TNF-α agents. At the same time, no significant evidence of difference was discovered in the comparison of preoperative UST and VDZ therapy in terms of overall complications, infectious complications (sepsis and abscess), and non infectious complications (intestinal obstruction, readmission, and recovery surgery).
In general, compared with other biological agents, preoperative use of UST in the treatment of CD patients is usually safe and does not increase surgical complications.

The Author(s). Published by S. Karger AG, Basel.