Exabis Library

This course has been developed for gastroenterologists, surgeons, paediatricians, pathologists and other interdisciplinary medical experts interested in Inflammatory Bowel Disease(s) (IBD). One major aim of this e-learning activity is to increase competence and knowledge with regard to the management of CD patients and to harmonise indications and technical considerations for surgery in order to improve patient outcomes.

Upon completion of this activity learners will:

• - Know how to identify surgical indications in patients with Crohn's Disease (CD)
  
• - Be able to adequately treat different complications in CD patients that require surgery
  
• - Be able to recommend appropriate changes in perioperative treatment and management

1. To understand the surgical strategies and surgical implications of surgery in IBD
2. To review surgical techniques and decision making in surgery for IBD
3. To emphasise multidisciplinary team working and patient involvement in decision making
4. To promote the role of the specialist IBD nurse in providing care, education, and counselling to Crohn and colitis ulcerosa patients

This course is designed for gastroenterologists, surgeons, paediatricians, pathologists and other interdisciplinary medical experts interested in Inflammatory Bowel Disease(s) (IBD). The intended result of this activity is increased competence, knowledge, performance and improved patient outcomes.

Upon completion of this activity learners will:

• Have insights into the position of surgery versus medical therapy in patients with moderate-to-severe as well as acute severe IV steroid refractory colitis (UC)
• Be able to select the most optimal surgical modalities
• Gain knowledge on the appropriate follow-up of patients with an ileal pouch-anal anastomosis (IPAA)

This presentation will focus on how to identify risks for surgical complications in surgery for inflammatory bowel disease, as well as how to decrease the risk prior to surgery. There will also be a discussion on how to act when surgical complications have developed, as this risk is increased compared to colorectal surgery in general.

Educational objectives:
1. To review when to perform surgical resection in CD, as illustrated with a patient journey with limited L1 Crohn's disease
2. To get an insight into the surgical procedure via video presentation
3. To summarize literature on risk-stratification, the importance of proactive monitoring and individual treatments for postoperative recurrence

1. to understand when and why surgery is indicated in selected patients with UC

2. to review the different surgical options in patient operated for ulcerative colitis

3. to precise the consequences  for the patient in terme of function, quality of life and follow up, after surgery for UC, according to the operation performed

4. to have an overwiew of the best way to follow a patient after ileal pouch-anal anastomosis for ulcerative colitis

5/ to review the possible problems occurring during follow up up of patients after ileal pouch-anal anastomosis and the treatment for each problem

Discussion about incidence of colorectal cancer, small bowel cancer, and anal cancer in IBD with a focus on surgical strategies

IBD and cancer: surgical strategy in UC

Educational objectives:
- To emphasise that cancer risk is depending on patient and disease characteristics, and varies with duration of disease
- To review the incidence of CRC rate in colectomy specimens over the last decades
- Give an overview of surgical approaches in case of UC malignancy and discuss ongoing controversies (proctocolectomy vs segmental resection/ pouch or not/ mucosectomy/  impact of (neo)-adjuvant therapy)

Surveillance Colonoscopy in IBD