Personalized pre-habilitation reduces anastomotic complications compared to up front surgery before ileocolic resection in high-risk patients with Crohn's disease: A single center retrospective study

Ferrandis, Charlotte; Souche, Regis; Bardol, Thomas; Boivineau, Lucile; Fabre, Jean‐Michel; Altwegg, Romain; Guillon, F.

doi:10.1016/j.ijsu.2022.106815

Cited by 15 publications

(10 citation statements)

References 34 publications

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“…The analysis of this subgroup showed no differences in the readmission rate and hospitalization time. Administration of biological treatment within 3 months before surgery was not a risk factor for postoperative complications [17].…”

Section: Prehabilitation In Ibdmentioning

confidence: 90%

“…Another paper presenting the benefits of prehabilitation is the paper by Ferrandis et al [17]. The authors analyzed the impact of personalized prehabilitation (PP) before ileocaecal resection, as the most common procedure in patients with CD, on postoperative complications of anastomosis in patients with CD in a group of 90 patients with a high risk of postoperative complications.…”

Section: Prehabilitation In Ibdmentioning

confidence: 99%

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Prehabilitation in preparing patients with inflammatory bowel diseases for surgery, including nutritional treatment and psychological support

Głuszek¹,

Głuszek-Osuch²,

Kozieł³

et al. 2023

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Despite progress in the pharmacological treatment of inflammatory bowel diseases (IBD), surgery is still an integral part of the treatment of ulcerative colitis and Crohn's disease. The probability of adverse effects of the procedure in this group of patients is related to the specificity of IBD and depends on modifiable and non-modifiable risk factors. Optimization of health must therefore rely on a multi-directional and individualized approach to a patient. Proper preparation of the patient for surgery consisting in nutritional and psychological support, improvement of physical efficiency and encouragement to give up addictions can bring a real benefit in improving the treatment results. The paper discusses the principles, benefits and limitations of the use of elements of prehabilitation in the surgical treatment of patients with IBD. StreszczeniePomimo postępu leczenia farmakologicznego nieswoistych chorób zapalnych jelit (NChZJ) chirurgia nadal jest integralną częścią terapii wrzodziejącego zapalenia jelita grubego i choroby Leśniowskiego-Crohna. Prawdopodobieństwo wystąpienia niepożądanych następstw zabiegu jest w tej grupie chorych związane ze specyfiką NChZJ oraz zależne od modyfikowalnych i niemodyfikowalnych czynników ryzyka. Optymalizacja stanu zdrowia musi polegać na wielokierunkowym i zindywidualizowanym podejściu do chorego. Właściwe jego przygotowanie do operacji polegające na wsparciu żywieniowym, psychologicznym, poprawie wydolności fizycznej i zachęceniu do rezygnacji z nałogów może przynieść realną korzyść dla poprawy wyników leczenia. W pracy omówiono zasady, korzyści i ograniczenia wykorzystania elementów prehabilitacji w leczeniu chirurgicznym pacjentów z NChZJ.

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Section: Prehabilitation In Ibdmentioning

confidence: 90%

Section: Prehabilitation In Ibdmentioning

confidence: 99%

Prehabilitation in preparing patients with inflammatory bowel diseases for surgery, including nutritional treatment and psychological support

Głuszek¹,

Głuszek-Osuch²,

Kozieł³

et al. 2023

View full text Add to dashboard Cite

show abstract

“…In high-risk patients with Crohn's disease before ileocolic resection, a personalized prehabilitation (PP) program reduces the number of preoperative risk factors. This way, a PP program allows primary anastomosis with a lower complication rate than in upfront operated patients [70].…”

Section: Surgical Planningmentioning

confidence: 99%

Colorectal Anastomosis: The Critical Aspect of Any Colorectal Surgery

Santos¹

2024

Current Concepts and Controversies in Laparoscopic Surgery

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Colorectal surgery has undergone an enormous technical evolution with the advent of laparoscopy and, more recently, the robotics approach. Technology, combined with the use of more advanced materials and the implementation of pre-habilitation and enhanced recovery after multimodal surgery programs, has allowed the performance of complex surgeries with excellent results. As a result, reaching optimal oncological, physiological, and cosmetic results associated with the patient’s better and shorter postoperative stay is possible. However, colorectal anastomosis is still a critical aspect of this process that always affects the final result of the surgery. Therefore, it has profound implications in the short, medium, and long term. When an anastomotic leak occurs, it is usually the surgeon’s biggest nightmare and can have devastating consequences for both the patient and the surgeon. This chapter’s aim pretended to reflect on how to avoid colorectal anastomotic leakage and, if it happens, how to detect and treat it early, trying to minimize the number and the consequence.

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“…14 A personalized prehabilitation program for high-risk patients with Crohn's disease requiring ileocolic resection, including enteral or parenteral nutrition when appropriate, has also been shown to reduce the rate of both anastomotic complications and re-operation. 15 Given that many Crohn's disease patients undergoing surgery are also being treated with immunosuppressive and biologic therapies, it may be hard to parse out the specific effects of malnutrition itself. However, it has been shown that malnutrition alone is an independent risk factor for postoperative morbidity and mortality irrespective of these medications.…”

Section: Preoperative Risk Factors For Anastomotic Complicationsmentioning

confidence: 99%

Anastomotic Considerations in Crohn's Disease

Kann

2022

Clin Colon Rectal Surg

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A number of factors should be considered when performing an intestinal anastomosis in the setting of surgery for Crohn's disease. Preoperative risk factors, such as malnutrition, abdominal sepsis, and immunosuppressive medications, may increase the risk of postoperative anastomotic complications and alter surgical decision-making. The anatomical configuration and technique of constructing the anastomosis may have an impact on postoperative function and risk of recurrence, particularly in the setting of ileocolic resection, where the Kono-S anastomosis has gained popularity in recent years. There may be circumstances in which it may be more appropriate to perform an ostomy either without an anastomosis or to temporarily divert an anastomosis when the risk of anastomotic complications is felt to be high. In the setting of total abdominal colectomy or proctocolectomy for Crohn's colitis, restorative procedures may appropriate in lieu of a permanent stoma in certain scenarios.

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Personalized pre-habilitation reduces anastomotic complications compared to up front surgery before ileocolic resection in high-risk patients with Crohn's disease: A single center retrospective study

Cited by 15 publications

References 34 publications

Prehabilitation in preparing patients with inflammatory bowel diseases for surgery, including nutritional treatment and psychological support

Prehabilitation in preparing patients with inflammatory bowel diseases for surgery, including nutritional treatment and psychological support

Colorectal Anastomosis: The Critical Aspect of Any Colorectal Surgery

Anastomotic Considerations in Crohn's Disease

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