Peri-Operative Optimization of Patients with Crohn's Disease.

Q1 Medicine Current Gastroenterology Reports Pub Date : 2024-05-01 Epub Date: 2024-02-29 DOI:10.1007/s11894-024-00925-9

Hareem Syed, Ahmed Nadeem, David Gardinier, Kendra Weekley, Dovid Ribakow, Stephen Lupe, Shubha Bhat, Stefan Holubar, Benjamin L Cohen

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Abstract

Purpose of review: The management of patients with Crohn's disease (CD) undergoing surgery is complex and optimization of modifiable factors perioperatively can improve outcomes. This review focuses on the perioperative management of CD patients undergoing surgery, emphasizing the need for a multi-disciplinary approach.

Recent findings: Research highlights the benefits of a comprehensive strategy, involving nutritional optimization, psychological assessment, and addressing septic complications before surgery. Despite many CD patients being on immune-suppressing medications, studies indicate that most of these medications are safe to use and should not delay surgery. However, a personalized approach for each case is needed. This review underscores the importance of multi-disciplinary team led peri-operative management of CD patients. We suggest that this can be done at a dedicated perioperative clinic for prehabilitation, with the potential to enhance outcomes for CD patients undergoing surgery.

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克罗恩病患者的围手术期优化。

审查目的：对接受外科手术的克罗恩病（CD）患者的管理非常复杂，优化围手术期可改变的因素可改善预后。本综述重点关注接受手术的克罗恩病患者的围手术期管理，强调多学科方法的必要性：研究强调了综合策略的益处，包括营养优化、心理评估以及术前处理败血症并发症。尽管许多 CD 患者正在服用免疫抑制药物，但研究表明，这些药物大多可以安全使用，不应延误手术。然而，每个病例都需要个性化的治疗方法。本综述强调了由多学科团队主导的 CD 患者围手术期管理的重要性。我们建议可以在专门的围手术期诊所进行术前康复治疗，这样有可能提高接受手术的 CD 患者的治疗效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Gastroenterology Reports Medicine-Gastroenterology

CiteScore

7.80

自引率

0.00%

发文量

期刊介绍： As the field of gastroenterology and hepatology rapidly evolves, the wealth of published literature can be overwhelming. The aim of the journal is to help readers stay abreast of such advances by offering authoritative, systematic reviews by leading experts. We accomplish this aim by appointing Section Editors who invite international experts to contribute review articles that highlight recent developments and important papers published in the past year. Major topics in gastroenterology are covered, including pediatric gastroenterology, neuromuscular disorders, infections, nutrition, and inflammatory bowel disease. These reviews provide clear, insightful summaries of expert perspectives relevant to clinical practice. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.

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