Report on the ECCO Topical Review: Roadmap to optimal peri-operative care in IBD
Shaji Sebastian, ClinCom Chair and Antonino Spinelli, ECCO Member
It is well known that the outcomes of surgery, and especially of IBD surgery, are not merely dependent on the operative procedure but are influenced by a number of factors before, during and after surgery. The multidisciplinary team involved in the care of IBD patients has the opportunity to optimise patient care and status prior to surgery to ensure optimal outcomes and reduce the risk of complications.
The goal of the joint ClinCom–S-ECCO Working Group behind the ECCO Topical Review “Roadmap to optimal peri-operative care in IBD” was to review the available evidence in a systematic way and to provide clinicians with a balanced, handy, multidisciplinary compendium of this evidence. The group has been led by Shaji Sebastian and Antonino Spinelli, who have been responsible for coordinating a group of IBD clinicians, surgeons, dietitians and other members of the multidisciplinary team with specific expertise and interest in the topic. This multidisciplinary panel of IBD health care providers, involving 15 representatives divided into four different working subgroups, systematically reviewed aspects relevant to peri-operative care in IBD and developed Consensus Statements using the modified Delphi methodology. As per normal ECCO SOP, we included Y-ECCO Members in each of these working subgroups.
A total of 20 current practice positions were developed following systematic review of the current literature, covering use of medication in the peri-operative period, nutritional assessment and intervention, physical and psychological rehabilitation and prehabilitation and immediate postoperative care. The result of this work is published this month in the JCC, with the conclusion that peri-operative planning and optimisation of the patient are imperative to ensure favourable outcomes and reduced morbidity. We hope that this ECCO Topical Review will stimulate the development of processes and protocols for peri-operative care in IBD tailored to the local unit. In addition, we call for further research into peri-operative care in IBD. We urge all members of the IBD Community to read this Topical Review, which provides practice recommendations applicable in the peri-operative period in IBD patients undergoing surgery.