G Li1, J Ren1, G Wang1, D Hu1, G Gu1, S Liu1, H Ren1, X Wu1, J Li1. 1. Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Abstract
BACKGROUND/ OBJECTIVES: Exclusive enteral nutrition (EEN) has been shown to be effective in the management of Crohn's disease (CD). However, few experiences have been reported regarding its role in postoperative intra-abdominal septic complications (IASCs) after bowel resections for enterocutaneous fistulas (ECFs). Our aim was to investigate the influence of preoperative 3-month EEN on the incidence of IASCs and to clarify the risk factors of IASCs in fistulizing CD. SUBJECTS/ METHODS: A retrospective study on 123 CD patients suffering from ECFs was conducted from February 2001 to April 2011. Fifty-five patients (44.7%) received preoperative 3-month EEN. The changes in serum albumin and C-reactive protein (CRP) were compared. Perioperative data were analyzed using logistic regression to identify the independent risk factors affecting the incidence of postoperative IASCs. RESULTS: Patients were similar in gender, age, fistula conditions and perioperative medications in the EEN and non-EEN groups. The EEN group had a significantly higher serum albumin level and lower CRP at operation, and suffered a lower risk of IASCs (3.6% vs 17.6%, P<0.05). Two years after operation when follow-up ended, the two groups had comparable cumulative risk of IASCs (P=0.109). A logistic regression analysis identified age at operation and preoperative EEN as independent risk factors of postoperative IASCs. CONCLUSIONS: Preoperative EEN reduced the risk of postoperative IASCs after operation for ECFs in CD. In addition, age at operation may be another factor of influence.
BACKGROUND/ OBJECTIVES: Exclusive enteral nutrition (EEN) has been shown to be effective in the management of Crohn's disease (CD). However, few experiences have been reported regarding its role in postoperative intra-abdominal septic complications (IASCs) after bowel resections for enterocutaneous fistulas (ECFs). Our aim was to investigate the influence of preoperative 3-month EEN on the incidence of IASCs and to clarify the risk factors of IASCs in fistulizing CD. SUBJECTS/ METHODS: A retrospective study on 123 CDpatients suffering from ECFs was conducted from February 2001 to April 2011. Fifty-five patients (44.7%) received preoperative 3-month EEN. The changes in serum albumin and C-reactive protein (CRP) were compared. Perioperative data were analyzed using logistic regression to identify the independent risk factors affecting the incidence of postoperative IASCs. RESULTS:Patients were similar in gender, age, fistula conditions and perioperative medications in the EEN and non-EEN groups. The EEN group had a significantly higher serum albumin level and lower CRP at operation, and suffered a lower risk of IASCs (3.6% vs 17.6%, P<0.05). Two years after operation when follow-up ended, the two groups had comparable cumulative risk of IASCs (P=0.109). A logistic regression analysis identified age at operation and preoperative EEN as independent risk factors of postoperative IASCs. CONCLUSIONS: Preoperative EEN reduced the risk of postoperative IASCs after operation for ECFs in CD. In addition, age at operation may be another factor of influence.
Authors: G Pellino; D S Keller; G M Sampietro; V Annese; M Carvello; V Celentano; C Coco; F Colombo; N Cracco; F Di Candido; M Franceschi; S Laureti; G Mattioli; L Pio; G Sciaudone; G Sica; V Villanacci; R Zinicola; S Leone; S Danese; A Spinelli; G Delaini; F Selvaggi Journal: Tech Coloproctol Date: 2020-01-25 Impact factor: 3.781
Authors: Johan Van Limbergen; Jennifer Haskett; Anne M Griffiths; Jeff Critch; Hien Huynh; Najma Ahmed; Jennifer C deBruyn; Robert Issenman; Wael El-Matary; Thomas D Walters; Cheryl Kluthe; Marie-Eve Roy; Elizabeth Sheppard; Wallace V Crandall; Stan Cohen; Frank M Ruemmele; Arie Levine; Anthony R Otley Journal: Can J Gastroenterol Hepatol Date: 2015-06-15
Authors: Kamal V Patel; Amir A Darakhshan; Nyree Griffin; Andrew B Williams; Jeremy D Sanderson; Peter M Irving Journal: Nat Rev Gastroenterol Hepatol Date: 2016-10-26 Impact factor: 46.802