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Inflammatory Bowel Disease V: Surgical Management

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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
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Perioperative optimization in complex abdominal wall hernias: Delphi consensus statement.

T N Grove1,2, C Kontovounisios1,2,3, A Montgomery4

  • 1Department of Surgery, Chelsea and Westminster Hospital, London, UK.

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Summary
This summary is machine-generated.

This study established global expert consensus on preoperative assessment and perioperative optimization for abdominal wall reconstruction (AWR). The recommendations provide a benchmark for managing complex hernias and improving patient outcomes.

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Area of Science:

  • Surgical Oncology
  • Gastroenterology
  • Abdominal Wall Reconstruction

Background:

  • High incidence of incisional hernias post-laparotomy (20-50%) necessitates complex abdominal wall reconstruction (AWR).
  • Patients undergoing AWR often have comorbidities, leading to complications and hernia recurrence.
  • Lack of global guidance highlights the need for standardized perioperative practices in AWR.

Purpose of the Study:

  • To establish a clear benchmark for preoperative assessment and perioperative optimization in patients undergoing AWR.
  • To provide global consensus guidelines for managing complex abdominal wall hernias.

Main Methods:

  • Utilized the Delphi method with 32 international hernia surgeons.
  • Employed anonymous web-based voting rounds with feedback, culminating in a live voting session.
  • Achieved consensus based on strong (≥80%) and weak (≥75%) agreement thresholds.

Main Results:

  • Consensus reached on 52 statements covering surgical and preoperative assessment, optimization, multidisciplinary care, and quality of life.
  • 46 statements achieved over 80% agreement, with 14 exceeding 95% agreement.
  • Established clear recommendations for AWR patient management.

Conclusions:

  • Presents global expert consensus recommendations for abdominal wall reconstruction (AWR).
  • Aims to serve as a baseline for surgeons and centers managing complex abdominal wall hernias.
  • Emphasizes standardized care for improved patient outcomes in AWR.