Perioperative optimization of Crohn's disease
Abstract Crohn's disease (CD) is a chronic inflammatory disease mainly affecting the gastrointestinal tract. With the increased availability of modalities in the last two decades, the treatment of CD has advanced remarkably. Although medical treatment is the mainstay of therapy, most patients r...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-01-01
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| Series: | Annals of Gastroenterological Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ags3.12621 |
| _version_ | 1828067558821986304 |
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| author | Chun‐Chi Lin Hung‐Hsin Lin Hui‐Chuen Chen Nai‐Chia Chen I‐Lun Shih Ji‐Shiang Hung Te‐Cheng Yueh Feng‐Fan Chiang Ping‐Wei Lin Yuan‐Yao Tsai Shu‐Chen Wei |
| author_facet | Chun‐Chi Lin Hung‐Hsin Lin Hui‐Chuen Chen Nai‐Chia Chen I‐Lun Shih Ji‐Shiang Hung Te‐Cheng Yueh Feng‐Fan Chiang Ping‐Wei Lin Yuan‐Yao Tsai Shu‐Chen Wei |
| author_sort | Chun‐Chi Lin |
| collection | DOAJ |
| description | Abstract Crohn's disease (CD) is a chronic inflammatory disease mainly affecting the gastrointestinal tract. With the increased availability of modalities in the last two decades, the treatment of CD has advanced remarkably. Although medical treatment is the mainstay of therapy, most patients require surgery during the course of their illness, especially those who experience complications. Nutritional optimization and ERAS implementation are crucial for patients with CD who require surgical intervention to reduce postoperative complications. The increased surgical risk was found to be associated with the use of corticosteroids, but the association of surgical risk with immunomodulators, biologic therapy, such as anti‐TNF mediations, anti‐integrin medications, and anti‐IL 12/23 was low in certainty. Decisions about preoperative medication must be made on an individual case‐dependent basis. Preoperative imaging studies can assist in the planning of appropriate surgical strategies and approaches. However, patients must be informed of any alterations to their treatment. In summary, the management of perioperative medications and surgery‐related decision‐making should be individualized and patient‐centered based on a multidisciplinary approach. |
| first_indexed | 2024-04-10T23:47:23Z |
| format | Article |
| id | doaj.art-d6a1c200e97b47e4b74b9a1a266c4bb7 |
| institution | Directory Open Access Journal |
| issn | 2475-0328 |
| language | English |
| last_indexed | 2024-04-10T23:47:23Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Gastroenterological Surgery |
| spelling | doaj.art-d6a1c200e97b47e4b74b9a1a266c4bb72023-01-11T02:40:41ZengWileyAnnals of Gastroenterological Surgery2475-03282023-01-0171102610.1002/ags3.12621Perioperative optimization of Crohn's diseaseChun‐Chi Lin0Hung‐Hsin Lin1Hui‐Chuen Chen2Nai‐Chia Chen3I‐Lun Shih4Ji‐Shiang Hung5Te‐Cheng Yueh6Feng‐Fan Chiang7Ping‐Wei Lin8Yuan‐Yao Tsai9Shu‐Chen Wei10Division of Colon & Rectal Surgery, Department of Surgery Taipei Veterans General Hospital Taipei TaiwanDivision of Colon & Rectal Surgery, Department of Surgery Taipei Veterans General Hospital Taipei TaiwanNational Taiwan University Hospital, Dietetics Department Taipei TaiwanNational Taiwan University Hospital, Dietetics Department Taipei TaiwanDepartment of Medical Imaging National Taiwan University Hospital Taipei TaiwanDivision of Colorectal Surgery, Department of Surgery National Taiwan University Hospital and College of Medicine Taipei TaiwanDivision of Colon and Rectal Surgery Taichung Armed Forces General Hospital Taichung TaiwanDivision of Colorectal Surgery, Department of Surgery Taichung Veterans General Hospital Taichung TaiwanDivision of colorectal surgery, Department of Surgery Mackay Memorial Hospital Taipei TaiwanDepartment of Colorectal Surgery China Medical University Hospital Taichung TaiwanDivision of Hepatology and Gastroenterology, Department of Internal Medicine National Taiwan University Hospital and College of Medicine Taipei TaiwanAbstract Crohn's disease (CD) is a chronic inflammatory disease mainly affecting the gastrointestinal tract. With the increased availability of modalities in the last two decades, the treatment of CD has advanced remarkably. Although medical treatment is the mainstay of therapy, most patients require surgery during the course of their illness, especially those who experience complications. Nutritional optimization and ERAS implementation are crucial for patients with CD who require surgical intervention to reduce postoperative complications. The increased surgical risk was found to be associated with the use of corticosteroids, but the association of surgical risk with immunomodulators, biologic therapy, such as anti‐TNF mediations, anti‐integrin medications, and anti‐IL 12/23 was low in certainty. Decisions about preoperative medication must be made on an individual case‐dependent basis. Preoperative imaging studies can assist in the planning of appropriate surgical strategies and approaches. However, patients must be informed of any alterations to their treatment. In summary, the management of perioperative medications and surgery‐related decision‐making should be individualized and patient‐centered based on a multidisciplinary approach.https://doi.org/10.1002/ags3.12621Crohn's diseaseenhanced recovery after surgerynutritional supportperioperative care |
| spellingShingle | Chun‐Chi Lin Hung‐Hsin Lin Hui‐Chuen Chen Nai‐Chia Chen I‐Lun Shih Ji‐Shiang Hung Te‐Cheng Yueh Feng‐Fan Chiang Ping‐Wei Lin Yuan‐Yao Tsai Shu‐Chen Wei Perioperative optimization of Crohn's disease Annals of Gastroenterological Surgery Crohn's disease enhanced recovery after surgery nutritional support perioperative care |
| title | Perioperative optimization of Crohn's disease |
| title_full | Perioperative optimization of Crohn's disease |
| title_fullStr | Perioperative optimization of Crohn's disease |
| title_full_unstemmed | Perioperative optimization of Crohn's disease |
| title_short | Perioperative optimization of Crohn's disease |
| title_sort | perioperative optimization of crohn s disease |
| topic | Crohn's disease enhanced recovery after surgery nutritional support perioperative care |
| url | https://doi.org/10.1002/ags3.12621 |
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