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Surgical Management

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Inflammatory Bowel Disease Nursing Manual

Abstract

Crohn’s disease (CD) is a chronic relapsing inflammatory disease, typically characterized by transmural inflammation of the intestine and could affect any part of the gastrointestinal tract, from mouth to perianal area. In terms of distribution of the disease 25% of the patients have colitis only, 25% ileitis only, and 50% ileocolitis. Approximately 70% of patients with CD require surgical intervention within 10 years of their initial diagnosis, with surgical recurrence in 25% of the patients by 5 years and 35% of the patients by 10 years after initial surgery. Ulcerative colitis (UC) is a chronic inflammatory bowel disease with mucosal inflammation that involves only the colon and the rectum, characterized by a proximal extension from rectum to cecum, without small bowel involvement. Surgery is still required in 15–35% of patients affected by UC, also in emergency setting. In this chapter we have analyzed clinical presentations of both diseases with surgical indications, type of surgery, and management of complications. In conclusion, we underline the importance of the role of IBD nurse in the management of all the complex situations that IBD patients live, solving problems and improving quality of life.

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References

  • Al-Darmaki A, Hubbard J, Seow CH, Leung Y, Novak K, Shaheen AA, Panaccione R, Kaplan GG (2017) Clinical predictors of the risk of early colectomy in ulcerative colitis: a population-based study. Inflamm Bowel Dis 23(8):1272–1277

    Article  Google Scholar 

  • Andrew RE, Messaris E (2016) Update on medical and surgical optionsfor patients with acute severe ulcerative colitis: what is new? World J Gastrointest Surg 8(9):598–605

    Article  Google Scholar 

  • Angriman I, Pirozzolo G, Bardini R, Cavallin F, Castoro C, Scarpa M (2017) A systematic review of segmental vs subtotal colectomy and subtotal colectomy vs total proctocolectomy for colonic Crohn’s disease. Color Dis 19(8):e279–e287

    Article  CAS  Google Scholar 

  • Bennett JL, Ha C, Efron JE, Gearhart SL, Lazarev MG, Wick EC (2015) Optimizing perioperative Crohn’s disease management: role of coordinated medical and surgical care. World J Gastroenterol 21(4):1182–1188

    Article  Google Scholar 

  • Coenen S, Weyts E, Vermeire S, Ferrante M, Noman M, Ballet V, Vanhaecht K, Van Assche G (2017) Effects of introduction of an inflammatory bowel disease nurse position on the quality of delivered care. Eur J Gastroenterol Hepatol 29(6):646–650

    Article  Google Scholar 

  • Cohen-Mekelburg S, Schneider Y, Gold S, Scherl E, Steinlauf A (2017) Advances in the diagnosis and management of colonic dysplasia in patients with inflammatory bowel disease. Gastroenterol Hepatol (N Y) 13(6):357–353

    Google Scholar 

  • de Barros KS, Flores C, Harlacher L, Francesconi CF (2017) Evolution of clinical behaviour in Crohn’s disease: factors associated with complicated disease and surgery. Dig Dis Sci 62(9):2481–2488

    Article  Google Scholar 

  • Gajendran M, Loganathan P, Catinella AP, Hashash JG (2017) A comprehensive review and update on Crohn’s disease. Dis Mon 64(2):20–57

    Article  Google Scholar 

  • Grass F, Pache B, Martin D, Hahnloser D, Demartines N, Hübner M (2017) Preoperative nutrional conditioning of Crohn’s patients-systematic review of current evidence and practice. Nutrients 9(6):E562

    Article  Google Scholar 

  • Hahnloser D, Pemberton J (2016) Long-term outcome after ileal pouch-anastomosis for ulcerative colitis. ANZ J Surg 86(10):741–742

    Article  Google Scholar 

  • Hata K, Ishihara S, Nozawa H, Kawai K, Kiyomatsu T, Tanaka T, Kishikawa J, Anzai H, Watanabe T (2017) Pouchitis after ileal pouch-anal anastomosis in ulcerative colitis: diagnosis, management, risk factors, incidence. Dig Endosc 29(1):26–34

    Article  Google Scholar 

  • Ide S, Araki T, Okita Y, Kawamura M, Toiyama Y, Kobayashi M, Ohi M, Tanaka K, Inoue Y, Uchida K, Mohri Y, Kusunoki M (2017) Outcome and functional prognosis of pelvic sepsis after ileal pouch-anal anastomosis in patients with ulcerative colitis. Surg Today 47(3):301–306

    Article  Google Scholar 

  • Kemp K, Fernandez E, Arnott I (2013) Impact of inflammatory bowel disease nurse specialist on quality of the patient journey. J Crohns Colitis 7(Suppl 1):203

    Article  Google Scholar 

  • Leach P, De Silva M, Mountifield R et al (2014) The effect of an inflammatory bowel disease nurse position on service delivery. J Crohns Colitis 8:370–374

    Article  Google Scholar 

  • Lee MJ, Heywood N, Sagar PM, Brown SR, Fearnhead N, ACPGBI Perianal Crohn’s Disease Group (2017) Association of coloproctology of Great Britain and Ireland consensus exercise on surgical management of fistulating perianal Crohn’s disease. Color Dis 19(5):418–429

    Article  CAS  Google Scholar 

  • Louis E, Dotan I, Ghosh S, Mlynarsky L, Reenaers C, Schreiber S (2015) Optimising the inflammatory bowel disease unit to improve quality of care: expert recomendations. J Crohns Colitis 9(8):685–691

    Article  Google Scholar 

  • Mosli MH, Parker CE, Nelson SA, Baker KA, MacDonald JK, Zou GY, Feagan BG, Khanna R, Levesque BG, Jairath V (2017) Histologic scoring indices for evaluation of disease activity in ulcerative colitis. Cochrane Database Syst Rev 5:CD011256

    PubMed  Google Scholar 

  • Nightingale AJ, Middleton W, Middleton SJ et al (2000) Evaluation of the effectiveness of a specialist nurse in the management of inflammatory bowel disease (IBD). Eur J Gastroenterol Hepatol 12:967–973

    Article  CAS  Google Scholar 

  • Olivera P, Spinelli A, Gower-Rousseau C, Danese S, Peyrin-Biroulet L (2017) Surgical rates in the era of biological therapy: up, down or unchanged? Curr Opin Gastroenterol 33(4):246–253

    Article  Google Scholar 

  • Panès J, Rimola J (2017) Perianal fistulizing Crohn’s disease: pathogenesis, diagnosis and therapy. Nat Rev Gastroenterol Hepatol 14(11):652–664

    Article  Google Scholar 

  • Ribaldone DG, Dileo I, Pellicano R, Resegotti A, Fagoonee S, Vernero M, Saracco G, Astegiano M (2017) Severe ulcerative colitis: predictors of response and algorithm proposal for rescue therapy. Ir J Med Sci 187(2):385–392

    Article  Google Scholar 

  • Rinawi F, Assa A, Eliakim R, Mozer Glassberg Y, Nachmias Friedler V, Niv Y, Rosenbach Y, Silbermintz A, Zevit N, Shamir R (2017) Predictors of pouchitis after ileal pouch-anal anastomosis in pediatric-onset ulcerative colitis. Eur J Gastroenterol Hepatol 29(9):1079–1085

    Article  Google Scholar 

  • Sevim Y, Akyol C, Aytac E, Baca B, Bulut O, Remzi FH (2017) Laparoscopic surgery for complex and recurrent Crohn’s disease. World J Gastrointest Endosc 9(4):149–152

    Article  Google Scholar 

  • Sobrado CW, Sobrado LF (2016) Management of acute severe ulcerative colitis: a clinical update. Arq Bras Cir Dig 29(3):201–205

    Article  Google Scholar 

  • Sofo L, Caprino P, Sacchetti F, Bossola M (2016) Restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis: a narrative review. World J Gastrointest Surg 8(8):556–563

    Article  Google Scholar 

  • Toh JW, Stewart P, Rickard MJ, Leong R, Wang N, Young CJ (2016) Indications and surgical options for small bowel, large bowel and perianal Crohn’s disease. World J Gastroenterol 22(40):8892–8904

    Article  Google Scholar 

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Correspondence to Antonino Spinelli .

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Di Candido, F.R., Radice, S., Spinelli, A. (2019). Surgical Management. In: Sturm, A., White, L. (eds) Inflammatory Bowel Disease Nursing Manual. Springer, Cham. https://doi.org/10.1007/978-3-319-75022-4_16

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  • DOI: https://doi.org/10.1007/978-3-319-75022-4_16

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-75021-7

  • Online ISBN: 978-3-319-75022-4

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