Surgical Management of Crohn Disease in Children: Guidelines from the Paediatric IBD Porto Group of ESPGHAN

Jorge Amil-Dias*, Sanja Kolacek, Dan Turner, Anders Pærregaard, Risto Rintala, Nadeem A. Afzal, Katarzyna Karolewska-Bochenek, Jiri Bronsky, Sonny Chong, John Fell, Iva Hojsak, Jean Pierre Hugot, Sibylle Koletzko, Devinder Kumar, Izabella Lazowska-Przeorek, Craig Lillehei, Paolo Lionetti, Javier Martin-De-Carpi, Mikko Pakarinen, Frank M. RuemmeleRon Shaoul, Christine Spray, Annamaria Staiano, Ian Sugarman, David C. Wilson, Harland Winter, Kaija Leena Kolho

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

74 Scopus citations

Abstract

The incidence of Crohn disease (CD) has been increasing and surgery needs to be contemplated in a substantial number of cases. The relevant advent of biological treatment has changed but not eliminated the need for surgery in many patients. Despite previous publications on the indications for surgery in CD, there was a need for a comprehensive review of existing evidence on the role of elective surgery and options in pediatric patients affected with CD. We present an expert opinion and critical review of the literature to provide evidence-based guidance to manage these patients. Indications, surgical options, risk factors, and medications in pre- and perioperative period are reviewed in the light of available evidence. Risks and benefits of surgical options are addressed. An algorithm is proposed for the management of postsurgery monitoring, timing for follow-up endoscopy, and treatment options.

Original languageAmerican English
Pages (from-to)818-835
Number of pages18
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume64
Issue number5
DOIs
StatePublished - 1 May 2017

Bibliographical note

Publisher Copyright:
Copyright © ESPGHAL and NASPGHAN. All rights reserved.

Keywords

  • Crohn disease
  • biologicals
  • complications
  • inflammatory bowel disease
  • surgery
  • treatment

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