The hostile abdomen dilemma: the safety of primary anastomosis in the presence of an intraoperative abscess in Crohn disease.

Among the 810 included patients (210 with an intraoperative abscess, 600 without), an abscess significantly increased operative complexity, resulting in higher rates of open conversion (29.3% vs 10.3%, P < .001) and fecal diversion (24.8% vs 6.2%, P < .001).

Furthermore, in the propensity score matched cohort of 474 patients, rates of anastomotic leak (10.1% vs 11.7%, P = .718), overall complications (41.1% vs 38.0%, P = .571), and severe complications (8.2% vs 10.8%, P = .480) were statistically identical between the abscess and non-abscess groups.