SP10.4 Pre-operative use of exclusive enteral nutrition in adult patients with Crohn’s disease: a single centre experience

Abstract

Abstract Introduction Exclusive enteral nutrition (EEN) in the management of adult patients with Crohn’s disease (CD) is thought to reduce post-operative complications but is under-utilised. This study aims to assess the use of EEN and post-operative outcomes in patients undergoing surgery for CD. Methods Consecutive adult patients at a single NHS Trust with CD undergoing surgery for stricturing, penetrating and medication-refractory disease from January 2018 to December 2021 were included. Patients prescribed at least 6 weeks of EEN prior to surgery (EEN) were compared to those who were not (non-EEN). Outcomes included intestinal failure (IF) requiring parenteral nutrition, post-operative complications, length of stay (LOS), unplanned readmission at 3 months and disease recurrence at 6 months. Results 142 patients were included, comprising 22 EEN and 120 non-EEN patients. There were no cases of postoperative IF in the EEN cohort, whilst 18.3% of non-EEN patients (22/120; p=0.04) developed type one IF. The mean LOS (days) was significantly less in the EEN group (8.3±3.6 vs. 15.9±17.3, p=0.04), as were the complication rates when using a Clavien Dindo score of ≥2 (13.6% vs. 36.7%, p=0.04). Outcomes for unplanned admission at 3 months (OR 0.44, p= 0.3) and disease recurrence at 6 months (OR 0.45, p= 0.3) favoured the EEN cohort but were not significant. Conclusion Consistent with other studies, our study demonstrated a potential benefit in post-operative outcomes in adult patients treated with at least 6 weeks of EEN. To fully utilize the benefits of EEN, potential candidates for surgery who will benefit from EEN need to be identified early.