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

Abstract

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. 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 4weeks, and the other patients had no nutritional therapy. All patients were followed up regularly for 2years after surgery, and ileocolonoscopy was performed every 6months after bowel resection. 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 4weeks (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 4weeks significantly reduced endoscopic recurrence rates after resection for CD 6months after operation. However, during the 2-year follow-up, incidence of clinical recurrence was similar in both groups (P>0.05). Preoperative exclusive EN therapy for 4weeks reduced postoperative complications, which may be associated with improvement of nutritional and inflammatory status in patients with active CD.