[成人克罗恩病管理的循证指南：PANCCO的建议]。
完整摘要 · 中文译文
引言：克罗恩病（CD）是一种慢性、复发性、进展性炎症性肠病，其发病率和患病率在拉丁美洲持续上升，与城市化和生活方式的西方化相关。其异质性的病程、累积性结构损伤以及对生活质量的影响，使得制定区域性推荐意见以指导受影响成年人的内科、内镜和外科治疗具有合理性。 目的：呈现泛美克罗恩病和结肠炎组织（PANCCO）指南中关于拉丁美洲成年克罗恩病管理的循证推荐意见。 方法学：本指南通过改编和更新哥伦比亚胃肠病学协会指南（2020年）制定，遵循泛美卫生组织/世界卫生组织（PAHO/WHO）指南制定方法。一个跨学科制定小组以PICO格式提出了七个临床问题；其中四个通过系统检索（2020年1月至2026年2月）在MEDLINE、Embase、Cochrane和Epistemonikos数据库中进行更新，使用AMSTAR-2、ROBIS、RoB 2.0和ROBINS-I进行质量评价，并使用GRADE系统进行证据确定性评级和推荐意见制定。 结果：共制定52条推荐意见，围绕七个临床问题组织，涉及复发预测、传统治疗诱导和维持缓解、中重度疾病的进阶治疗、瘘管性肛周疾病、外科-内镜方法以及术后复发的预防，并辅以良好临床实践要点。 结论：本指南汇集了最新的证据 现已可用于成人克罗恩病的治疗，纳入了先进疗法的使用、肛周瘘性疾病的多学科管理以及手术和治疗性内镜的作用，在拉丁美洲特定资源和需求的背景下为临床决策提供了一个实用框架。
完整摘要 · 英文原文
INTRODUCTION: Crohn's disease (CD) is a chronic, relapsing, and progressive inflammatory bowel disease whose incidence and prevalence have steadily increased in Latin America, associated with urbanization and the Westernization of lifestyles. Its heterogeneous course, cumulative structural damage, and impact on quality of life justify regional recommendations to guide the medical, endoscopic, and surgical treatment of affected adults. OBJECTIVE: To present the evidence-informed recommendations of the Pan American Crohn's and Colitis Organisation (PANCCO) guidelines for the management of CD in Latin American adults. METHODOLOGY: The guidelines were developed by adapting and updating the guidelines of the Colombian Association of Gastroenterology (2020), following PAHO/WHO guidelines. An interdisciplinary development group formulated seven clinical questions in PICO format; Four were updated through systematic searches (January 2020-February 2026) in MEDLINE, Embase, Cochrane, and Epistemonikos, with quality assessment using AMSTAR-2, ROBIS, RoB 2.0, and ROBINS-I, and certainty rating and recommendation formulation using the GRADE system. RESULTS: Fifty-two recommendations were formulated, organized around seven clinical questions on relapse prediction, induction and maintenance of remission with conventional therapy, advanced therapy in moderate to severe disease, fistulizing perianal disease, surgical-endoscopic approach, and prevention of postoperative recurrence, supplemented with points of good clinical practice. CONCLUSIONS: This guideline compiles the most recent evidence available for the treatment of Crohn's disease in adults, incorporating the use of advanced therapies, the multidisciplinary management of fistulizing perianal disease, and the role of surgery and therapeutic endoscopy, offering a practical framework for clinical decision-making within the context of resources and needs specific to Latin America.