Appraisal of current surgical guidelines for inflammatory bowel disease using the AGREE-S instrument: A scoping review

Aim: Guidelines play a crucial role in improving patient care by providing clinicians with up to date evidence-based recommendations. A vast number of guidelines exist on the surgical management of inflammatory bowel disease (IBD). The aim of this scoping review was to identify current surgical IBD guidelines, assess their quality and identify areas of variation between the existing guidelines.

Method: A systematic search of the literature from January 2008 to September 2023 was conducted. After identifying eligible guidelines, they were assessed for quality using the Appraisal of Guidelines for Research and Evaluation for Surgical Interventions (AGREE-S) instrument. Data were extracted on descriptive guideline characteristics and recommendations.

Results: Fifteen guidelines were identified globally. Most guidelines were published between 2011 and 2023, with six focusing solely on Crohn's disease, five on ulcerative colitis and four on both. Six guidelines focused exclusively on surgical management, while nine contained both medical and surgical recommendations. The overall mean AGREE-S score was 59%, with more recent guidelines scoring higher.

Conclusions: The quality of IBD surgical guidelines varies considerably. High-quality, collaborative, international guidelines are needed to reduce duplication and ensure consistent, evidence-based surgical care for IBD patients worldwide. Future guideline development should adhere to the AGREE-S criteria to enhance methodological rigour and transparency.