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Impact of Preoperative Exclusive Enteral Nutrition on Postoperative Complications and Recurrence After Bowel Resection in Patients with Active Crohn’s Disease

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Abstract

Background

The impact of preoperative enteral nutrition (EN) on postoperative complications and recurrence in Crohn’s disease (CD) has not been investigated to date. The purpose of the present study was to determine the effect of preoperative exclusive EN on postoperative complications and recurrence after bowel resection in patients with active CD.

Methods

Patient data were obtained from a prospectively maintained database. 81 patients who received bowel resection for ileal or ileocolonic CD were studied. Before operation, 42 CD patients received exclusive EN for 4 weeks, and the other patients had no nutritional therapy. All patients were followed up regularly for 2 years after surgery, and ileocolonoscopy was performed every 6 months after bowel resection.

Results

Patients receiving exclusive EN had a dramatic improvement of nutritional (BMI, albumin, pre-albumin, and Hb) and inflammatory (CRP and CDAI) status compared with baseline after the EN therapy for 4 weeks (P < 0.05). Furthermore, significantly lower incidence of both infectious and non-infectious complications was observed in patients receiving exclusive EN compared with those received no nutritional therapy (P < 0.05). Exclusive EN therapy for 4 weeks significantly reduced endoscopic recurrence rates after resection for CD 6 months after operation. However, during the 2-year follow-up, incidence of clinical recurrence was similar in both groups (P > 0.05).

Conclusions

Preoperative exclusive EN therapy for 4 weeks reduced postoperative complications, which may be associated with improvement of nutritional and inflammatory status in patients with active CD.

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Acknowledgments

This work was supported in part by funding from the National Ministry of Health for the Digestive Disease (Grant 201002020), the National Natural Science Foundation of China (Grant 81200263 and 81170365), and Jiangsu Provincial Special Program of Medical Science (BL2012006).

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Authors and Affiliations

  1. Department of General Surgery, Taizhou People’s Hospital, The Fifth Affiliated Hospital of Nantong University, No. 210 Yingchun Road, Taizhou, Jiangsu, China

    Honggang Wang & Qinghong Liu

  2. Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, Jiangsu, China

    Honggang Wang, Lugen Zuo, Jie Zhao, Jianning Dong, Yi Li, Lili Gu, Jianfeng Gong & Weiming Zhu

  3. Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, Jiangsu, China

    Jianning Dong

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  1. Honggang Wang
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Correspondence to Qinghong Liu or Weiming Zhu.

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Wang, H., Zuo, L., Zhao, J. et al. Impact of Preoperative Exclusive Enteral Nutrition on Postoperative Complications and Recurrence After Bowel Resection in Patients with Active Crohn’s Disease. World J Surg 40, 1993–2000 (2016). https://doi.org/10.1007/s00268-016-3488-z

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  • DOI: https://doi.org/10.1007/s00268-016-3488-z

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