Does exclusive enteral nutrition reduce the rate of stoma formation in patients requiring ileocolic resection for Crohn's disease? A single center experience

Autor: Shruti Webb–Butler, Wendy Lewis, Caris E. Grimes, Nivedita Ghosh, Rose Ross, Ayeshah Gordon–Dixon, Anur Miah, Rumneek Hampal
Rok vydání: 2021
Předmět:
Zdroj: Clinical Nutrition ESPEN. 44:282-286
ISSN: 2405-4577
DOI: 10.1016/j.clnesp.2021.05.030
Popis: Summary Background and aim Nutrition has a role in achieving and maintaining remission in Crohn's disease. The aim of this study was to determine the impact of a strategy of steroid-avoidance and Exclusive Enteral Nutrition (EEN) for 6 weeks (with a minimum of 4 weeks) in adult patients presenting with acute small bowel Crohn's disease followed by an interval ileocolic resection 4–6 weeks later. Methods Retrospective review of prospectively collected data. Patients were administered exclusive enteral nutrition (EEN) for at least 4 weeks prior to surgery. Results 24 EEN patients included. Median age of 45 (range 23–73). 17/24 patients tolerated Modulen for at least 4 weeks, 5 were switched to Ensures and 2 a liquid diet. 6 patients underwent surgery earlier than planned. Prior to surgery, there was no change in the mean BMI, albumin increased from a mean of 36 g/L (range 25–43) to 40 g/L (range 30–48). CRP levels decreased by a mean of 35.8 mg/L overall. 19 (79%) of operations were performed laparoscopically. 6 of the cases were re-do operations. All but 3 patients avoided a stoma at the time of the original operation. There were 5 post-operative complications: 1 anastomotic leak in a patient with a BMI of 42, 3 cases of paralytic ileus and 2 wound infections. Median length of stay was 7 days (range 3–76 days). Only 2 patients were readmitted within the 30-day post-operative period. Conclusion The pre-operative use of EEN appears to avoid unnecessary stoma formation with acceptable clinical outcomes.
Databáze: OpenAIRE
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