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Surg Clin North Am. 2019 Dec;99(6):1083-1094. doi: 10.1016/j.suc.2019.08.002. Epub 2019 Sep 11.

Preoperative Considerations in Inflammatory Bowel Disease.

Author information

1
Department of Surgery, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA.
2
Digestive Diseases Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. Electronic address: lightna@ccf.org.

Abstract

Patients with ulcerative colitis and Crohn's disease often present to surgery malnourished and on combination immunosuppression. These factors affect operation selection and postoperative outcomes. Corticosteroids have a well-established detrimental effect on postoperative outcomes, whereas the impact of biologic agents is more controversial. In a patient exposed to these medications, and in the presence of other risk factors, temporary intestinal diversion is likely the best choice. Enteral nutrition may help optimize malnourished patients at high risk of adverse postoperative outcomes.

KEYWORDS:

Biologics; Corticosteroids; Crohn's disease; Enteral nutrition; Preoperative medications; Ulcerative colitis

PMID:
31676049
DOI:
10.1016/j.suc.2019.08.002
[Indexed for MEDLINE]

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