PTH-198 Preoperative parenteral nutrition in crohn’s disease patients requiring abdominal surgery

Abstract Background and Aims Intestinal failure [IF] is a feared complication of Crohn’s disease [CD]. Although cumulative loss of small bowel due to bowel resections is thought to be the dominant cause, the causes and outcomes have not been reported. Methods Consecutive adult patients referred to a national intestinal failure unit over 2000–2018 with a diagnosis of CD, and subsequently treated with parenteral nutrition during at least 12 months, were included in this longitudinal cohort study. Data were extracted from a prospective institutional clinical database and patient records. Results A total of 121 patients were included. Of these, 62 [51%] of patients developed IF as a consequence of abdominal sepsis complicating abdominal surgery; small bowel resection, primary disease activity, and proximal stoma were less common causes [31%, 12%, and 6%, respectively]. Further, 32 had perianastomotic sepsis, and 15 of those had documented risk factors for anastomotic dehiscence. On Kaplan-Meier analysis, 40% of all patients regained nutritional autonomy within 10 years and none did subsequently; 14% of patients developed intestinal failure-associated liver disease. On Kaplan-Meier analysis, projected mean age of death was 74 years.2 Conclusions IF is a severe complication of CD, with 60% of patients permanently dependent on parenteral nutrition. The most frequent event leading directly to IF was a septic complication following abdominal surgery, in many cases following intestinal anastomosis in the presence of significant risk factors for anastomotic dehiscence. A reduced need for abdominal surgery, an increased awareness of perioperative risk factors, and structured pre-operative optimisation may reduce the incidence of IF in CD.

Download Full-text

Mo1913 - Impact of Parenteral Nutrition on Postoperative Outcomes in Crohn's Disease Patients Undergoing Major Abdominal Surgery

Gastroenterology ◽

10.1016/s0016-5085(18)32877-4 ◽

2018 ◽

Vol 154 (6) ◽

pp. S-849

Author(s):

Fares Ayoub ◽

Amir Kamel ◽

Naueen A. Chaudhry ◽

Atif Iqbal ◽

Sanda Tan ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Abdominal Surgery ◽

Parenteral Nutrition ◽

Major Abdominal Surgery ◽

Postoperative Outcomes

Download Full-text

Pre-operative total parenteral nutrition improves post-operative outcomes in a subset of Crohn’s disease patients undergoing major abdominal surgery

Gastroenterology Report ◽

10.1093/gastro/goy033 ◽

2018 ◽

Vol 7 (2) ◽

pp. 107-114 ◽

Cited By ~ 3

Author(s):

Fares Ayoub ◽

Amir Y Kamel ◽

Ahmed Ouni ◽

Naueen Chaudhry ◽

Yan Ader ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Abdominal Surgery ◽

Parenteral Nutrition ◽

Total Parenteral Nutrition ◽

Major Abdominal Surgery ◽

Operative Outcomes

Download Full-text

Su2024 – Use of Preoperative Total Parenteral Nutrition is Associated with Clinical and Laboratory Remission in Severe Active Crohn’s Disease

Gastroenterology ◽

10.1016/s0016-5085(19)38656-1 ◽

2019 ◽

Vol 156 (6) ◽

pp. S-694

Author(s):

Nitzan Kolonimos ◽

Marc S. Berns ◽

Liat Hai Katvan ◽

Michal Zelcer ◽

Ossama A. Hatoum ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Parenteral Nutrition ◽

Total Parenteral Nutrition

Download Full-text

Hypophosphatemia in patient with Crohn's disease on parenteral nutrition due to unexpected causes: case report

Clinical Nutrition ESPEN ◽

10.1016/j.clnesp.2021.09.415 ◽

2021 ◽

Vol 46 ◽

pp. S689-S690

Author(s):

D. Ljubas Kelecic ◽

Ana Barisic ◽

Irena Karas ◽

Andreja Horvat ◽

Darija Vranesic Bender ◽

...

Keyword(s):

Crohn’S Disease ◽

Case Report ◽

Crohn's Disease ◽

Parenteral Nutrition

Download Full-text

Purine analogues as a risk factor of postoperative complications in abdominal surgery for Crohn’s disease

Gastroenterology Review ◽

10.5114/pg.2012.27217 ◽

2012 ◽

Vol 1 ◽

pp. 13-19

Author(s):

Katarzyna Borycka-Kiciak ◽

Adam Kiciak ◽

Łukasz Janaszek ◽

Paweł Jaworski ◽

Wiesław Tarnowski

Keyword(s):

Risk Factor ◽

Crohn’S Disease ◽

Postoperative Complications ◽

Crohn's Disease ◽

Abdominal Surgery ◽

Purine Analogues

Download Full-text

Quality of Life Considering Patients with Chronic Inflammatory Bowel Diseases - Natural and Parenteral Nutrition

Polish Journal of Surgery ◽

10.2478/pjs-2014-0073 ◽

2014 ◽

Vol 86 (9) ◽

Cited By ~ 1

Author(s):

Aneta Raczkowska ◽

Michał Ławiński ◽

Aleksandra Gradowska ◽

Urszula Zielińska-Borkowska

Keyword(s):

Quality Of Life ◽

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Parenteral Nutrition ◽

Inflammatory Bowel Diseases ◽

Nutritional Therapy ◽

Bowel Diseases ◽

Inflammatory Bowel

AbstractOne of the elements of treatment considering inflammatory bowel diseases is nutritional therapy. The duration of the above-mentioned depends on the prevalence of such symptoms as fever, bowel move-ments, length of the functioning gastrointestinal tract, stoma and intestinal fistula presence. Nutritional therapy is an essential element of successful treatment alongside pharmacological, surgical, and biological therapy, as well as other methods. Crohn's disease and ulcerative colitis considered as chronic diseases, lead towards physical and biopsychosocial disability, being responsible for the reduction in the quality of life.was to determine the quality of life after surgical procedures in case of patients diagnosed with Crohn's disease and ulcerative colitis, subjected to natural and parenteral nutrition.The study group comprised 52 patients from the Department of Gastroen-terology, Military Medical Institute, and Department of Surgery and Clinical Nutrition, Clinical Hospital in Warsaw. The study was performed between October, 2011 and April, 2012. The World Health Organization Quality of Life Instrument - Bref (WHOQOL-BREF) questionnaire was used to deter-mine the patients’ quality of life.A lower quality of life was observed in case of patients subjected to parenteral nutrition, poor education, disease symptoms exacerbation, in the majority-rural inhabitants. The quality of life does not depend on gender, type of disease, family status, and additional medical care.

Download Full-text