ECCO Topical Review: Roadmap to Optimal Peri-Operative Care in IBD

Author:

Sebastian Shaji12ORCID,Segal Jonathan P34ORCID,Hedin Charlotte56ORCID,Pellino Gianluca7ORCID,Kotze Paulo Gustavo8ORCID,Adamina Michel910ORCID,Campmans-Kuijpers Marjo11ORCID,Davies Justin12,de Vries Annemarie C13ORCID,Casbas Ana Gutiérrez14ORCID,El-Hussuna Alaa15ORCID,Juillerat Pascal16ORCID,Meade Susanna17ORCID,Millán Monica18ORCID,Spinelli Antonino1920ORCID

Affiliation:

1. IBD Unit, Hull University Teaching Hospitals , Hull , UK

2. Hull York Medical School, University of Hull , Hull , UK

3. Northern Hospital Epping , Melbourne , Australia

4. University of Melbourne , Parkville, Melbourne , Australia

5. Department of Medicine, Karolinska Institutet , Solna, Stockholm , Sweden

6. Gastroenterology Unit, Department of Gastroenterology, Dermatovenereology and Rheumatology, Karolinska University Hospital , Stockholm , Sweden

7. Department of Advanced Medical and Surgical Sciences, Universitá degli Studi della Campania ‘Luigi Vanvitelli’ , Naples , Italy

8. Colorectal Surgery Unit, Pontificia Universidade Católica do Paraná [PUCPR] , Curitiba , Brazil

9. Department of Surgery, Cantonal Hospital Winterthur , Winterthur , Switzerland

10. Faculty of Medicine, University of Basel , Basel , Switzerland

11. Department of Gastroenterology and Hepatology, University Medical Centre Groningen , Groningen , the Netherlands

12. Cambridge Colorectal Unit, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust , Cambridge , UK

13. Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam , Rotterdam , the Netherlands

14. Gastroenterology Department, Hospital General Universitario de Alicante, ISABIAL and CIBERehd , Alicante , Spain

15. OpenSourceResearch organisation (osrc.network) , Aalborg , Denmark

16. Clinic for Visceral Surgery and Medicine, Inselspital, University Hospital of Bern , Bern , Switzerland

17. Department of Gastroenterology, Guy’s and Saint Thomas’ Hospitals NHS Trust , London , UK

18. General Surgery, Colorectal Unit, Hospital Universitari i Politecnic La Fe , Valencia , Spain

19. Department of Biomedical Sciences, Humanitas University , Milan , Italy

20. IRCCS Humanitas Research Hospital , Milan , Italy

Abstract

Abstract Background and aims Despite the advances in medical therapies, a significant proportion of patients with inflammatory bowel diseases [IBD] require surgical intervention. This Topical Review aims to offer expert consensus practice recommendations for peri-operative care to optimize outcomes of IBD patients who undergo surgery. Methods A multidisciplinary panel of IBD healthcare providers systematically reviewed aspects relevant to peri-operative care in IBD. Consensus statements were developed using Delphi methodology. Results A total of 20 current practice positions were developed following systematic review of the current literature covering use of medication in the peri-operative period, nutritional assessment and intervention, physical and psychological rehabilitation and prehabilitation, and immediate postoperative care. Conclusion Peri-operative planning and optimization of the patient are imperative to ensure favourable outcomes and reduced morbidity. This Topical Review provides practice recommendations applicable in the peri-operative period in IBD patients undergoing surgery.

Funder

European Crohn’s and Colitis Organisation

Publisher

Oxford University Press (OUP)

Subject

Gastroenterology,General Medicine

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