title: European Society of Coloproctology consensus on the surgical management of intestinal failure in adults.
abstract: Intestinal failure (IF) is a debilitating condition of inadequate nutrition due to an anatomical and/or physiological deficit of the intestine. Surgical management of patients with acute and chronic IF requires expertise to deal with technical challenges and make correct decisions. Dedicated IF units have expertise in patient selection, operative risk assessment and multidisciplinary support such as nutritional input and interventional radiology, which dramatically improve the morbidity and mortality of this complex condition and can beneficially affect the continuing dependence on parenteral nutritional support. Currently there is little guidance to bridge the gap between general surgeons and specialist IF surgeons. Fifteen European experts took part in a consensus process to develop guidance to support surgeons in the management of patients with IF. Based on a systematic literature review, statements were prepared for a modified Delphi process. The evidence for each statement was graded using Oxford Centre for Evidence-Based Medicine Levels of Evidence. The current paper contains the statements reflecting the position and practice of leading European experts in IF encompassing the general definition of IF surgery and organization of an IF unit, strategies to prevent IF, management of acute IF, management of wound, fistula and stoma, rehabilitation, intestinal and abdominal reconstruction, criteria for referral to a specialist unit and intestinal transplantation.
authors.affiliation: The Lennard Jones Intestinal Failure Unit, St Mark's Hospital, Northwick Park, Harrow, UK.|Imperial College London, London, UK.
authors.forename: C J
authors.initials: CJ
authors.lastname: Vaizey
authors.affiliation: The Lennard Jones Intestinal Failure Unit, St Mark's Hospital, Northwick Park, Harrow, UK.|Imperial College London, London, UK.
authors.forename: Y
authors.initials: Y
authors.lastname: Maeda
authors.affiliation: Serviço de Cirurgia, Hospital Pedro Hispano, Senhora da Hora, Portugal.
authors.forename: E
authors.initials: E
authors.lastname: Barbosa
authors.affiliation: Faculty of Medicine, University of Milan, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Bozzetti
authors.affiliation: Department of General, Digestive, Hepato-Biliary-Pancreatic Surgery and Abdominal Organ Transplantation Unit, University Hospital 12 de Octubre, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Calvo
authors.affiliation: Gastrosurgery Research Group, UiT the Arctic University of Norway, University Hospital North-Norway, Tromsø, Norway.|Department of Gastroenterologic Surgery, University Hospital North-Norway, Tromsø, Norway.
authors.forename: Ø
authors.initials: Ø
authors.lastname: Irtun
authors.affiliation: Department of Medical Gastroenterology CA-2121, Rigshospitalet, Copenhagen, Denmark.
authors.forename: P B
authors.initials: PB
authors.lastname: Jeppesen
authors.affiliation: General and Oncology Surgery, General and Oncology Unit, Stanley Dudrick's Memorial Hospital, Skawina, Poland.
authors.forename: S
authors.initials: S
authors.lastname: Klek
authors.affiliation: Department for Perioperative Nutrition, Clinic for General Surgery, Military Medical Academy, Belgrade, Serbia.
authors.forename: M
authors.initials: M
authors.lastname: Panisic-Sekeljic
authors.affiliation: 2nd Department of Surgery, Areteion Hospital, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: I
authors.initials: I
authors.lastname: Papaconstantinou
authors.affiliation: Department of General, Visceral, Vascular, Thoracic and Transplant Surgery, Charité - Universitaetsmedizin Berlin, Berlin, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Pascher
authors.affiliation: Colorectal Department, Beaujon Hospital and University Paris VII, Clichy, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Panis
authors.affiliation: Northern Ireland Regional Intestinal Failure Service, Belfast City Hospital, Belfast, UK.
authors.forename: W D
authors.initials: WD
authors.lastname: Wallace
authors.affiliation: National Intestinal Failure Centre, Salford Royal NHS Foundation Trust, University of Manchester, Salford, Manchester, UK.
authors.forename: G
authors.initials: G
authors.lastname: Carlson
authors.affiliation: Department of Surgery/Intestinal Failure Team, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Boermeester
mesh_terms: D032921:Consensus; D006801:Humans; D008286:Malabsorption Syndromes / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D044342:Malnutrition / Q000209:etiology / Q000628:therapy*; D010288:Parenteral Nutrition; D014883:Water-Electrolyte Imbalance / Q000209:etiology / Q000628:therapy*