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

Shaji Sebastian; Jonathan P Segal; Charlotte Hedin; Gianluca Pellino; Paulo Gustavo Kotze; Michel Adamina; Marjo Campmans-Kuijpers; Justin Davies; Annemarie C de Vries; Ana Gutiérrez Casbas; Alaa El-Hussuna; Pascal Juillerat; Susanna Meade; Monica Millán; Antonino Spinelli

doi:10.1093/ecco-jcc/jjac129

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

J Crohns Colitis. 2023 Mar 18;17(2):153-169. doi: 10.1093/ecco-jcc/jjac129.

Authors

Shaji Sebastian^{1

2}, Jonathan P Segal^{3

4}, Charlotte Hedin^{5

6}, Gianluca Pellino⁷, Paulo Gustavo Kotze⁸, Michel Adamina^{9

10}, Marjo Campmans-Kuijpers¹¹, Justin Davies¹², Annemarie C de Vries¹³, Ana Gutiérrez Casbas¹⁴, Alaa El-Hussuna¹⁵, Pascal Juillerat¹⁶, Susanna Meade¹⁷, Monica Millán¹⁸, Antonino Spinelli^{19

20}

Affiliations

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.

PMID: 36055337
DOI: 10.1093/ecco-jcc/jjac129

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.

Keywords: IBD; Peri-operative care; Surgery.

Publication types

Systematic Review

MeSH terms

Humans
Inflammatory Bowel Diseases* / drug therapy
Inflammatory Bowel Diseases* / surgery
Postoperative Care

Grants and funding

European Crohn's and Colitis Organisation