Crohn's disease in children and adolescents: Is inadequate weight gain a valid indication for surgery?

Benner, Jon W.; Weintraub, William H.; Wesley, John R.; Coran, Arnold G.

doi:10.1016/s0022-3468(79)80492-3

Cited by 14 publications

(4 citation statements)

References 8 publications

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“…We also found that there was a significant increase in weight z score ( P < 0.0001) and height z score ( P < 0.0001). Benner et al (22) reported that of 26 patients who underwent bowel resection for CD, 22 were below the third centile for weight preoperatively, and more than 60% subsequently gained weight postoperatively. In our study 74% of children demonstrated an improvement in BMI by 12 months after surgery, with the majority of children experiencing no BMI improvement 12 months after surgery being the ones who relapsed within 1 year.…”

Section: Discussionmentioning

confidence: 99%

Surgery in Children With Crohn Disease Refractory to Medical Therapy

Pacilli¹,

Eaton

Fell

et al. 2011

J. pediatr. gastroenterol. nutr.

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Section: Discussionmentioning

confidence: 99%

Surgery in Children With Crohn Disease Refractory to Medical Therapy

Pacilli¹,

Eaton

Fell

et al. 2011

J. pediatr. gastroenterol. nutr.

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“…In Benner et al's series of 26 patients who underwent bowel resection for CD, 22 were below the third centile for weight preoperatively, and over 60% subsequently gained weight post-operatively[29]. Although Besnard et al[18] demonstrated a mean increase in weight after surgery of 2.11 kg in 17 patients, the standard deviation for this value was 8.…”

mentioning

confidence: 97%

Surgery results in significant improvement in growth in children with Crohn’s disease refractory to medical therapy

et al. 2006

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Inflammatory bowel disease (IBD) in children can cause significant impairment in linear growth, and delay in pubertal onset. The aim of this study was to assess the impact of surgery on linear growth in children with Crohn's disease (CD) who were resistant to medical therapy, and had documented evidence of growth impairment. We performed a retrospective study on eight consecutive patients with refractory disease who had attended the paediatric IBD clinic. All patients underwent surgery as part of their treatment. Height and weight were recorded at least 6 months prior to surgery, at the time of surgery, and 6 months post surgery. Growth velocities and height Z-scores were calculated. All patients had evidence of sustained growth suppression prior to surgery. Three patients had evidence of growth failure. There was a significant increase in height velocity from 0.15 cm/month before surgery to 0.54 cm/month after surgery (P = 0.006). There was also a significant decrease in the modified Harvey-Bradshaw index (HBI) of disease activity from 2.00 before surgery, to 0.84 after surgery (P = 0.003). Improvements in height Z-score and weight velocity after surgery were not significant on statistical analysis. Our study demonstrates that before surgery, children with CD refractory to therapy have sustained growth suppression, and in some cases may even have growth failure. Surgical intervention before puberty appears to result in a significant improvement in height velocity and disease activity. These findings need to be further investigated with carefully designed prospective studies.

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“…Our studies suggest that when surgical resection is required for obstructive complications of Crohn's disease, a l-month period of bowel rest and total parenteral nutrition may maximize postoperative growth in early pubertal adolescents. As emphasized in previous studies, surgical resection of active disease is associated with improved caloric intake, weight gain, and modest increase in growth (29)(30)(31)(32) , but does not seem to guarantee optimal growth response. In closing, it must be emphasized that in patients capable of appropriate oral or intragastric feedings, enteric alimentation allows for an equivalent growth response (10,11,12), especially when symptomatic IBD is controlled with alternate-day corticosteroid use (33).…”

Section: Discussionmentioning

confidence: 90%

Influence of Preoperative Parenteral Alimentation on Postoperative Growth in Adolescent Crohn's Disease

Lake,

Kim,

Mathis

et al. 1985

J. pediatr. gastroenterol. nutr.

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The postoperative growth rates achieved in eight early pubertal adolescent males with Crohn's disease undergoing surgery for obstructive complications is reported as a function of the use of 1 month's preoperative central venous alimentation. All patients had ileal strictures with ileocolitis, bone ages less than 13, Tanner stages 1 or 2, and growth velocities below the 3rd percentile for age. During a 3‐year follow‐up, those receiving preoperative venous alimentation demonstrated greater oral caloric intake (significant for 1 year) and greater postoperative growth velocity (significant for 2 years) in comparison to those patients who did not receive preoperative venous alimentation. There was no significant difference between the two groups of patients in postoperative weight gain, sexual development, and 3‐year disease control.

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Crohn's disease in children and adolescents: Is inadequate weight gain a valid indication for surgery?

Cited by 14 publications

References 8 publications

Surgery in Children With Crohn Disease Refractory to Medical Therapy

Surgery in Children With Crohn Disease Refractory to Medical Therapy

Surgery results in significant improvement in growth in children with Crohn’s disease refractory to medical therapy

Influence of Preoperative Parenteral Alimentation on Postoperative Growth in Adolescent Crohn's Disease

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