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Colorectal SurgeryManagement

Crohn's Disease Surgical Planning Algorithm (ASCRS)

Crohn's Disease Surgical Planning Algorithm (ASCRS): Crohn's Disease: Surgical Candidate → Preoperative Optimization → Disease Location → Ileocolic Dise...

Pathway Overview

11 steps

Algorithm Steps

11 total

  1. 01Start

    Crohn's Disease: Surgical Candidate

  2. 02Action

    Preoperative Optimization

    Nutrition, steroids wean if possible, abscess drainage

  3. 03Decision

    Disease Location

    • Ileocolic
    • Small bowel
    • Colonic
    • Perianal
  4. 04Action

    Ileocolic Disease

    Most common surgical site

  5. 05End

    Ileocolic Resection

    Stapled side-to-side anastomosis

  6. 06Action

    Small Bowel Only

    Stricture pattern

  7. 07End

    Stricturoplasty

    Heineke-Mikulicz or Finney for multiple strictures

  8. 08Action

    Colonic Disease

    Segmental vs total involvement

  9. 09End

    Segmental Colectomy

    Avoid subtotal if possible

  10. 10Action

    Perianal Disease

    Abscess, fistula, stricture

  11. 11End

    EUA + Seton/Drainage

    Anti-TNF bridge to surgery

Guideline Source

ASCRS Clinical Practice Guidelines: Surgical Management of Crohn's Disease

DOI: 10.1097/DCR.0000000000002323View Guideline

Clinical Safety Information

Clinical Decision Support — Not a Substitute for Clinical Judgment

Individual patient factors may require deviation from these recommendations.

Known Limitations

  • Crohn's recurs after surgery - bowel preservation critical
  • Anastomotic leak risk higher in Crohn's
  • Nutritional optimization before elective surgery

Applicable Regions

USAUUKEU

EU: ECCO surgical guidelines

US: ASCRS guidelines

Version 1Next review: 2028-01-01

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Frequently Asked Questions

What is the Crohn's Disease Surgical Planning Algorithm (ASCRS)?

The Crohn's Disease Surgical Planning Algorithm (ASCRS) is a management clinical algorithm for Colorectal Surgery. It provides a structured decision tree to guide clinical decision-making, based on ASCRS Clinical Practice Guidelines: Surgical Management of Crohn's Disease.

What guideline is the Crohn's Disease Surgical Planning Algorithm (ASCRS) based on?

This algorithm is based on ASCRS Clinical Practice Guidelines: Surgical Management of Crohn's Disease (DOI: 10.1097/DCR.0000000000002323).

What are the limitations of the Crohn's Disease Surgical Planning Algorithm (ASCRS)?

Known limitations include: Crohn's recurs after surgery - bowel preservation critical; Anastomotic leak risk higher in Crohn's; Nutritional optimization before elective surgery. Individual patient factors may require deviation from these recommendations.

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