Timing of individualized surgical intervention in Crohn’s disease

Xia, Kai; Gao, Renyuan; Wu, Xiaodi; Yin, Lu; Chen, Chun-Qiu

doi:10.4240/wjgs.v14.i12.1320

Cited by 2 publications

(3 citation statements)

References 85 publications

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“…81 Moreover, the presence of intra-abdominal abscesses is associated with an increased risk of anastomotic complications. 5,82 In addition, the presence of a phlegmon or an abscess reduces the likelihood of a minimally invasive approach to surgery. 83 Therefore, it is imperative to control abscesses and phlegmons prior to any surgical intervention.…”

Section: Intraabdominal Abscessesmentioning

confidence: 99%

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Preoperative Optimization of Crohn's Patients before Abdominopelvic Surgery

Moussally,

Paski,

Cohen

et al. 2024

Clin Colon Rectal Surg

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In this article, we review and identify modifiable risk factors associated with postoperative complications of Crohn's disease. We highlight the importance of factors such as nutrition, corticosteroids, immunomodulators, abscesses, ideal timing of surgery, and biologic and small-molecule therapy on surgical outcomes. Herein, we discuss the strategies for attenuating these risk factors. Special consideration is given to venous thromboembolism prophylaxis in this patient population.

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Section: Intraabdominal Abscessesmentioning

confidence: 99%

“…[1][2][3][4] It is thought that the cumulative surgery rate 30 years after symptom onset is as high as 94.5%. 5 As such, perioperative optimization of patients with CD is of utmost importance in mitigating the risk of perioperative complications. Multiple modifiable and nonmodifiable risk factors for complications have been identified.…”

mentioning

confidence: 99%

Preoperative Optimization of Crohn's Patients before Abdominopelvic Surgery

Moussally,

Paski,

Cohen

et al. 2024

Clin Colon Rectal Surg

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show abstract

“…Regarding CD patients, conservative treatment aims at the disappearance of the symptoms of the disease, the healing of the intestinal mucosa, the improvement of the quality of life, and the prevention of complications. Surgery represents the second “hand” of the comprehensive treatment of CD, although the decision to choose the most appropriate time to perform the surgery has been controversial for a long time[ 1 ]. However, despite the significant improvements achieved in the conservative treatment of CD, these did not significantly change the need for surgical treatment since two-thirds of patients need to undergo surgery at some point in the course of their disease.…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of inflammatory bowel disease: From the gastroenterologist’s stand-point

Triantafillidis

2024

World J Gastrointest Surg

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Treatment of ulcerative colitis (UC) and Crohn’s disease (CD) represents, in the majority of cases, a real challenge to the gastroenterologist’s abilities and skills as well as a clinical test concerning his/her levels of medical knowledge and experience. During the last two decades, our pharmaceutical arsenal was significantly strengthened, especially after the introduction of the so-called biological agents, drugs which to a large extent not only improved the results of conservative treatment but also changed the natural history of the disease. However, colectomy is still necessary for some patients with severe UC although smaller compared to the past, precisely because of the improvements achieved in the available conservative treatment. Nevertheless, surgeries to treat colon dysplasia and cancer are increasing to some extent. At the same time, satisfactory improvements in surgical techniques, the pre-and post-operative care of patients, as well as the selection of the appropriate time for performing the surgery have been noticed. Regarding patients with CD, the improvement of conservative treatment did not significantly change the need for surgical treatment since two-thirds of patients need to undergo surgery at some point in the course of their disease. On the other hand, the outcome of the operation has improved through good preoperative care as well as the wide application of more conservative surgical techniques aimed at keeping as much of the bowel in situ as possible. This article discusses the indications for surgical management of UC patients from the gastroenterologist’s point of view, the results of the emerging new techniques such as transanal surgery and robotics, as well as alternative operations to the classic ileo-anal-pouch anastomosis. The author also discusses the basic principles of surgical management of patients with CD based on the results of the relevant literature. The self-evident is emphasized, that is, to achieve an excellent therapeutic result in patients with severe inflammatory bowel disease in today’s era; the close cooperation of gastroenterologists with surgeons, pathologists, imaging, and nutritionists is of paramount importance.

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Timing of individualized surgical intervention in Crohn’s disease

Cited by 2 publications

References 85 publications

Preoperative Optimization of Crohn's Patients before Abdominopelvic Surgery

Preoperative Optimization of Crohn's Patients before Abdominopelvic Surgery

Surgical treatment of inflammatory bowel disease: From the gastroenterologist’s stand-point

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