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 Wilson, Harland Winter, Kaija-Leena Kolho, IBD Working Group of ESPGHAN (IBD Porto Group)

Research output: Contribution to journalArticlepeer-review

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 languageEnglish
Pages (from-to)818-835
Number of pages18
JournalJournal of pediatric gastroenterology and nutrition
Volume64
Issue number5
DOIs
Publication statusPublished - 1 May 2017

Keywords

  • Journal Article

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