Few studies have reported the systematic use of exclusive enteral nutrition in the perioperative setting.
Dr Heerasing and colleagues from the United Kingdom tested the hypothesis that exclusive enteral nutrition provides a safe and effective bridge to surgery and reduces post-operative complications, in adult patients with Crohn's disease requiring urgent surgery for stricturing or penetrating complications.
Patients treated with exclusive enteral nutrition prior to surgery were each matched with 2 control patients for disease behavior, type of surgery, age at diagnosis and disease duration.
Data on disease phenotype, nutritional status, operative course and post-operative complications were obtained.
|The median length of surgery was shorter in patients pre-optimized with exclusive enteral nutrition|
|Alimentary Pharmacology & Therapeutics|
The research team found that 25% of patients treated with exclusive enteral nutrition avoided surgery.
The team observed that exclusive enteral nutrition had no effect on pre-operative weight, but it significantly reduced serum CRP vs pre-operation.
The median length of surgery was shorter in patients pre-optimized with exclusive enteral nutrition than controls.
The researchers confirmed that going straight-to-surgery compared exclusive enteral nutrition pre-optimization was associated with a 9-fold increase in the incidence of post-operative abscess and/or anastomotic leak.
Dr Heerasing's team concludes, "Exclusive enteral nutrition frequently down-stages the need for surgery in patients presenting with stricturing or penetrating complications of Crohn's disease."
"It is associated with a reduction in systemic inflammation, operative times, and the incidence of post-operative abscess or anastomotic leak."
"Further trials are needed to elucidate how exclusive enteral nutrition may improve operative outcomes."