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 Ahmad Afzal, Katarzyna Karolewska-Bochenek, Jiri Bronsky, Sonny Chong, John M E Fell, Iva Hojsak, Jean-Pierre Hugot, Sibylle Koletzko, Devinder Kumar, Izabella Lazowska-Przeorek, Craig Lillehei, Paolo Lionetti, Javier Martín-de-Carpi, Mikko Pakarinen, Frank M RuemmeleRon Shaoul, Christine Spray, Annamaria Staiano, Ian Sugarman, David C Wilson, Harland Winter, Kaija-Leena Kolho, IBD Working Group of ESPGHAN (IBD Porto Group)

74 Citations (Scopus)

Abstract

The incidence of Crohn's 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 peri-operative 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 post-surgery monitoring, timing for follow-up endoscopy and treatment options.

Original languageEnglish
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume64
Issue number5
Pages (from-to)818-835
ISSN0277-2116
DOIs
Publication statusPublished - 1 May 2017

Keywords

  • Journal Article

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