生物制剂已经转变了炎症性肠病（IBD）的管理方式。然而，在复杂的IBD中，肠道切除仍然是不可避免的。目前还存在争议，即在接受TNF-α抗肿瘤坏死因子治疗的小儿IBD患者中是否存在更高的术后并发症。因此，我们旨在分析儿童IBD患者术前使用抗-TNF-α药物与术后并发症之间的数据。我们在4个数据库中进行了系统性文献搜索，以比较术前12周内接受抗-TNF-α治疗和未接受抗-TNF-α治疗的IBD患儿之间术后并发症的发生率。为了分析这个问题，我们用95%置信区间（CI）计算了汇总的比值（OR）。OR大于1表示术前使用抗-TNF-α药物的儿童并发症发生率更高，而OR小于1表示并发症发生率更低。计算I²值来衡量研究异质性的强度，较小的百分比意味着较低的异质性。 我们发现了8篇符合条件的文章，总共526名小儿IBD患者。主要结果是总体并发症。汇总并发症的OR为1.38（95% CI，0.10-18.76；P = .65；I2 = 34%）。与此相反，感染和非感染性并发症的OR分别为0.59（95% CI，0.21-1.69;P = .16;I2= 0%）和0.48（95% CI，0.18-1.25；p = .09；I2 = 0%），尽管两者都显示出无显着差异的结果。 在小儿IBD患者肠道切除术后使用术前抗-TNF-α治疗与术后并发症之间没有明显的关联。然而，由于研究数量较少，证据不足。©作者（2023）版权所有，由牛津大学出版社代表Crohn's & Colitis Foundation出版。保留所有权利。如需获得许可，请发送电子邮件至：journals.permissions@oup.com。

Biological agents have transformed the management of inflammatory bowel disease (IBD). However, intestinal resection is still unavoidable in complicated IBD. It is still under debate whether antitumor necrosis factor (TNF)-α is related to higher postoperative complications in children with IBD. Therefore, we aimed to analyze data on preoperative anti-TNF-α and postoperative complications in pediatric IBD.We conducted a systematic literature search in 4 databases for studies that compared the incidence of postoperative complications between children with IBD who received anti-TNF-α treatment within 12 weeks prior to intestinal resection and who did not receive anti-TNF-α before the operation. To analyze this question, pooled odds ratios (ORs) were calculated with 95% confidence intervals (CIs). Odds ratios higher than 1 mean higher complication rate among children treated with preoperative anti-TNF-α, whereas an OR lower than 1 means lower complication rate. The I² value was calculated to measure the strength of the between-study heterogeneity, where a smaller percentage means the lower heterogeneity.We found 8 eligible articles with 526 pediatric patients with IBD. The primary outcome was the overall complication. The pooled OR of overall complications was 1.38 (95% CI, 0.10-18.76; P = .65; I2 = 34%) in contrast, the OR of infectious and noninfectious complications were 0.59 (95% CI, 0.21-1.69; P = .16; I2 = 0%) and 0.48 (95% CI, 0.18-1.25; p = .09; I2 = 0%), although both showed a nonsignificant result.There is no significant association between preoperative anti-TNF-α therapy and postoperative complications in children with IBD after intestinal resection. However, the evidence is low due to the low number of studies investigating this question.© The Author(s) 2023. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.