ECCO Guidelines on Therapeutics in Crohn's Disease: Surgical Treatment

Michel Adamina; Stefanos Bonovas; Tim Raine; Antonino Spinelli; Janindra Warusavitarne; Alessandro Armuzzi; Oliver Bachmann; Palle Bager; Livia Biancone; Bernd Bokemeyer; Peter Bossuyt; Johan Burisch; Paul Collins; Glen Doherty; Alaa El-Hussuna; Pierre Ellul; Gionata Fiorino; Cornelia Frei-Lanter; Federica Furfaro; Christian Gingert; Paolo Gionchetti; Javier P Gisbert; Fernando Gomollon; Marien González Lorenzo; Hannah Gordon; Tibor Hlavaty; Pascal Juillerat; Konstantinos Katsanos; Uri Kopylov; Eduards Krustins; Torsten Kucharzik; Theodore Lytras; Christian Maaser; Fernando Magro; John Kenneth Marshall; Pär Myrelid; Gianluca Pellino; Isadora Rosa; Joao Sabino; Edoardo Savarino; Laurents Stassen; Joana Torres; Mathieu Uzzan; Stephan Vavricka; Bram Verstockt; Oded Zmora

doi:10.1093/ecco-jcc/jjz187

ECCO Guidelines on Therapeutics in Crohn's Disease: Surgical Treatment

J Crohns Colitis. 2020 Feb 10;14(2):155-168. doi: 10.1093/ecco-jcc/jjz187.

Authors

Michel Adamina^{1

2}, Stefanos Bonovas^{3

4}, Tim Raine⁵, Antonino Spinelli⁶, Janindra Warusavitarne⁷, Alessandro Armuzzi⁸, Oliver Bachmann⁹, Palle Bager¹⁰, Livia Biancone¹¹, Bernd Bokemeyer¹², Peter Bossuyt¹³, Johan Burisch¹⁴, Paul Collins¹⁵, Glen Doherty¹⁶, Alaa El-Hussuna¹⁷, Pierre Ellul¹⁸, Gionata Fiorino^{3

4}, Cornelia Frei-Lanter¹⁹, Federica Furfaro⁴, Christian Gingert²⁰, Paolo Gionchetti²¹, Javier P Gisbert²², Fernando Gomollon²³, Marien González Lorenzo³, Hannah Gordon²⁴, Tibor Hlavaty²⁵, Pascal Juillerat²⁶, Konstantinos Katsanos²⁷, Uri Kopylov²⁸, Eduards Krustins²⁹, Torsten Kucharzik³⁰, Theodore Lytras³¹, Christian Maaser³², Fernando Magro³³, John Kenneth Marshall³⁴, Pär Myrelid³⁵, Gianluca Pellino³⁶, Isadora Rosa³⁷, Joao Sabino³⁸, Edoardo Savarino³⁹, Laurents Stassen⁴⁰, Joana Torres⁴¹, Mathieu Uzzan⁴², Stephan Vavricka⁴³, Bram Verstockt⁴⁴, Oded Zmora⁴⁵

Affiliations

¹ Department of Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland.
² University of Basel, Basel, Switzerland.
³ Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
⁴ IBD Center, Humanitas Clinical and Research Center, Milan, Italy.
⁵ Department of Gastroenterology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
⁶ Humanitas Clinical and Research Center, Division of Colon and Rectal Surgery, Humanitas University, Department of Biomedical Sciences, Milan, Italy.
⁷ Imperial College London, Department of Surgery and Cancer, St Mark's Hospital, Department of Gastroenterology, London, UK.
⁸ IBD Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS - Universita' Cattolica del Sacro Cuore, Rome, Italy.
⁹ Department of Internal Medicine I, Siloah St Trudpert Hospital, Pforzheim, Germany.
¹⁰ Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
¹¹ Department of Systems Medicine, University 'Tor Vergata' of Rome, Rome, Italy.
¹² Gastroenterology Practice Minden, Minden, Germany.
¹³ Imelda GI Clinical Research Centre, Imelda General Hospital, Bonheiden, Belgium.
¹⁴ Gastrounit, Medical Division, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark.
¹⁵ Department of Gastroenterology, Royal Liverpool University Hospital, Liverpool, UK.
¹⁶ Department of Gastroenterology and Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland.
¹⁷ Department of Surgery, Aalborg University Hospital, Aalborg, Denmark.
¹⁸ Department of Medicine, Division of Gastroenterology, Mater Dei Hospital, Msida, Malta.
¹⁹ Department of Surgery, Hospital Zollikerberg, Zollikerberg Zürich, Switzerland.
²⁰ Visceral Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland; Department of Human Medicine, Faculty of Health, University of Witten/Herdecke, Witten, Germany.
²¹ IBD Unit, DIMEC, University of Bologna, Bologna, Italy.
²² Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa [IIS-IP], Universidad Autónoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBEREHD], Madrid, Spain.
²³ IBD UNIT, Hospital Clíico Universitario 'Lozano Blesa', IIS Aragón, CIBEREHD, Zaragoza, Spain.
²⁴ Department of Gastroenterology, Barts Health NHS Trust, Royal London Hospital, London, UK.
²⁵ Fifth Department of Internal Medicine, Sub-department of Gastroenterology and Hepatology, University Hospital Bratislava and Faculty of Medicine, Comenius University Bratislava, Slovakia.
²⁶ Clinic for Visceral Surgery and Medicine, Inselspital, University Hospital of Bern, Bern, Switzerland.
²⁷ Department of Gastroenterology and Hepatology, University and Medical School of Ioannina, Ioannina, Greece.
²⁸ Department of Gastroenterology, Tel-HaShomer Sheba Medical Center, Ramat Gan, Israel; and Sackler Medical School, Tel Aviv, Israel.
²⁹ Department of Gastroenterology, Hepatology and Nutrition, Pauls Stradins Clinical University Hospital, Department of Internal Medicine, Riga Stradiņš University, Riga, Latvia.
³⁰ Department of Internal Medicine and Gastroenterology, Hospital Lüneburg, Lüneburg, Germany.
³¹ National Public Health Organization, Athens, Greece.
³² Outpatients Department of Gastroenterology, Hospital Lüneburg, Lüneburg, Germany.
³³ Department of Pharmacology and Therapeutics; Institute for Molecular and Cell Biology, University of Porto, Faculty of Medicine, Porto, Portugal.
³⁴ Department of Medicine [Division of Gastroenterology] and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada.
³⁵ Department of Surgery, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
³⁶ Department of Advanced Medical and Surgical Sciences, Universitá degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy.
³⁷ Department of Gastroenterology, IPOLFG, Lisbon, Portugal.
³⁸ Department of Gastroenterology and Hepatology, University Hospitals, KU Leuven, Leuven, Belgium.
³⁹ Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.
⁴⁰ Department of General Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands.
⁴¹ Department of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal.
⁴² Department of Gastroenterology, IBD unit, Beaujon Hospital, APHP, Clichy, France.
⁴³ Division of Gastroenterology and Hepatology, University Hospital, Zürich, Switzerland.
⁴⁴ Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium, and Department of Chronic Diseases, Metabolism and Ageing, TARGID - IBD, KU Leuven, Leuven, Belgium.
⁴⁵ Department of Surgery, Shamir Medical Center [Assaf Harofe], Tel Aviv, Israel.

PMID: 31742338
DOI: 10.1093/ecco-jcc/jjz187

Abstract

This article is the second in a series of two publications relating to the European Crohn's and Colitis Organisation [ECCO] evidence-based consensus on the management of Crohn's disease. The first article covers medical management; the present article addresses surgical management, including preoperative aspects and drug management before surgery. It also provides technical advice for a variety of common clinical situations. Both articles together represent the evidence-based recommendations of the ECCO for Crohn's disease and an update of previous guidelines.

Keywords: Crohn’s disease; inflammatory bowel disease [IBD]; surgery.

Publication types

Practice Guideline

MeSH terms

Abdominal Abscess / etiology
Abdominal Abscess / surgery
Crohn Disease / complications
Crohn Disease / surgery*
Crohn Disease / therapy
Humans
Intestinal Obstruction / etiology
Intestinal Obstruction / surgery
Intestine, Small / surgery
Rectal Fistula / etiology
Rectal Fistula / surgery