P724 Long-term outcomes of exclusive enteral nutrition in the peri-operative period for Crohn’s disease: A seven year follow-up study

Abstract

Abstract Background Exclusive enteral nutrition (EEN) is a recommended first-line treatment for Crohn’s disease flares in the paediatric population. Its use has yet to translate widely to the adult population. There is growing evidence for the use of EEN in the pre-operative setting to downstage the disease process and improve short term surgical outcomes. Little is known in this context regarding the long term effects of pre-operative EEN. Our study reports on follow up data for a cohort of patients who underwent surgery following pre-optimisation with EEN compared to those who did not. We assessed long term complications, disease recurrence and disease control as our key outcomes. Methods We carried out a seven year follow up study of the patients included in a retrospective, matched cohort trial conducted in a single, tertiary care, inflammatory bowel disease centre, in the UK. Patients pre- optimised with EEN prior to surgery were compared to a matched control cohort. Results Median follow up period was seven and six years for EEN and control groups respectively. Patients in the EEN group were more likely to be on maintenance medical therapy compared to control (73.47% vs 46.67%, p=0.005), however, admission rates and clinical recurrence rates were similar between groups (32.65% vs 24.66%, p=0.33 and 71.43% vs 65.58%, p=0.42). There was a moderate difference in complication rates beyond six months in favour of the EEN group (5.55% vs 17.80%, p=0.08). EEN patients were more likely to need further surgery however, this observation was not sustained when surgery for peri-anal disease was excluded (22.45% vs 13.69%, p=0.21) Conclusion Pre-optimising patients with EEN prior to Crohn’s disease surgery may improve short term surgical outcomes, it is unlikely to improve long term disease outcomes, based on results from this study.