Peri-Operative Optimization of Patients with Crohn's Disease

Curr Gastroenterol Rep. 2024 Feb 29. doi: 10.1007/s11894-024-00925-9. Online ahead of print.

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.

Keywords: Crohn’s disease; Immunosuppression; Intra-abdominal abscesses; Nutrition; Peri-operative.

Publication types

  • Review