Exclusive enteral nutrition provides an effective bridge to safer interval elective surgery for adults with Crohn's disease

Heerasing, Neel; Thompson, Beth; Hendy, Peter; Heap, Graham A.; Walker, Gareth; Bethune, Rob; Mansfield, Stephen; Calvert, C. C.; Kennedy, Nicholas A; Ahmad, Tariq; Goodhand, James

doi:10.1111/apt.13934

Cited by 109 publications

(157 citation statements)

References 35 publications

(76 reference statements)

Supporting

Mentioning

140

Contrasting

Unclassified

Order By: Relevance

“…Heerasing et al [58] retrospectively revised 51 patients treated with preoperative EEN after nutritional assessment. Thirteen patients (25%) ended up not requiring surgery.…”

Section: Resultsmentioning

confidence: 99%

“…Compared to their respective controls, patients under preoperative EEN achieved significantly lower levels of preoperative inflammatory markers in three of the reviewed studies [58-60], in two of which with concomitant increases in serum albumin values [59, 60]. The two studies with the greatest number of patients found preoperative EEN to be an independent factor against postoperative infectious and non-infectious complications [57] and against anastomotic leaks or abscesses [58]. …”

Section: Resultsmentioning

confidence: 99%

“…However, quality grading for risk of bias according to NOS criteria [38] (Table 3) qualifies only one of the studies as “fair quality” [58] – the only one to match compared patient groups. The remaining studies were considered “poor quality,” essentially for not scoring in the comparability domain (see online suppl.…”

Section: Resultsmentioning

confidence: 99%

“…Both reviewed Western studies made use of orally administered polymeric EEN [58, 59]. In both cases, an enriched formula with transforming growth factor beta-2 (TGF-β2) was used, the advantages of which have been studied for this pathology but not yet proved [17, 24, 68].…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Preoperative Enteral Nutrition and Surgical Outcomes in Adults with Crohn’s Disease: A Systematic Review

Rocha

Bessa

Lago

et al. 2018

GE Port J Gastroenterol

View full text Add to dashboard Cite

Background and Aim: Enteral nutrition (EN) is applicable to adult Crohn’s disease (CD) in treating malnutrition and in inducing remission – here as a less effective alternative than corticosteroids. The purpose of this review is to determine whether preoperative EN impacts postoperative complications of adult CD, either by means of nutritional or therapeutic effects. Summary: A systematic review of English written full-text research articles published between January 1990 and November 2017, including adult patients undergoing abdominal surgery for complicated CD after EN, was performed. Four studies out of 22 were selected, all of which institutional, retrospective, case-control cohorts, one classified as “good quality” and three as “poor quality,” as rated by the Newcastle-Ottawa Scale. The application of inclusion and exclusion criteria resulted in a non-intentional absence of studies referring to supplemental EN among those reviewed. The reduced number of heterogeneous eligible studies impeded meta-analysis. In all studies, exclusive EN (EEN) was used and well tolerated, allowing to defer or even avoid surgery altogether, improving patients’ global state. The two studies with the greatest number of patients found preoperative EEN to be an independent factor against infectious and non-infectious complications in 219 patients and against anastomotic leaks or abscesses in 38 patients. Also, in univariate analysis, EEN was found to increase preoperative immunosuppressant-free intervals and to protect against anastomotic dehiscences, intra-abdominal abscesses, surgical wound infections, ileus, stomas, and reoperations in the largest study; in another study it was related to fewer intra-abdominal septic complications. Key Messages: All reviewed studies are retrospective and, consequently, of limited relevance. Nonetheless, all of them call the attention of the scientific community to the potential benefits of preoperative EEN on postoperative outcomes in adult CD, calling for prospective multi-institutional studies and randomized controlled trials.

show abstract

“…Heerasing et al [58] retrospectively revised 51 patients treated with preoperative EEN after nutritional assessment. Thirteen patients (25%) ended up not requiring surgery.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Preoperative Enteral Nutrition and Surgical Outcomes in Adults with Crohn’s Disease: A Systematic Review

Rocha

Bessa

Lago

et al. 2018

GE Port J Gastroenterol

View full text Add to dashboard Cite

show abstract

“…Previous studies reported in western countries that partial enteral nutrition was showed to be an effective option for maintaining remission and perioperative management [31, 32]. ESPEN guideline recommended the use of elemental nutrition (EN) in CD patients with symptomatic intestinal strictures or stenosis [33].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcome of Endoscopic Balloon Dilatation for Strictures in Patients with Crohn’s Disease

et al. 2018

View full text Add to dashboard Cite

Background/Aims: Endoscopic balloon dilatation (EBD) is an alternative to surgery for strictures in patients with Crohn’s disease (CD). The aim of the present study was to clarify the efficacy and safety of EBD for strictures in patients with CD. Methods: Twenty-six patients with CD who underwent EBD for strictures from August 2008 to November 2015 were followed up after dilatation. Short-term success was defined as the disappearance of obstructive symptoms after technically adequate dilatation was achieved. The short-term success rate of EBD, safety profile of EBD, and cumulative surgery-free and redilatation-free rates were analyzed. Results: Sixty-five EBDs were performed for CD patients in the follow-up period. The short-term success rate was 100% (26/26), and no complications were encountered during this study. Two (7.7%) patients underwent surgery during the observation period. The cumulative surgery-free rate after the initial EBD was 90.3% at both 2 and 3 years. The cumulative redilatation-free rate after the initial EBD was 52.1% at 2 years and 39.1% at 3 years. Conclusion: EBD for strictures secondary to CD provides not only short-term success but also long-term efficacy. Although a high redilatation rate is one of the clinical problems of this procedure, EBD is an effective therapy for avoiding intestinal recession in CD stricture.

show abstract

Nutrition support in inflammatory bowel disease

Lomer

2018

Advanced Nutrition and Dietetics in Nutrition Support

View full text Add to dashboard Cite

Exclusive enteral nutrition provides an effective bridge to safer interval elective surgery for adults with Crohn's disease

Cited by 109 publications

References 35 publications

Preoperative Enteral Nutrition and Surgical Outcomes in Adults with Crohn’s Disease: A Systematic Review

Preoperative Enteral Nutrition and Surgical Outcomes in Adults with Crohn’s Disease: A Systematic Review

Long-Term Outcome of Endoscopic Balloon Dilatation for Strictures in Patients with Crohn’s Disease

Nutrition support in inflammatory bowel disease

Contact Info

Product

Resources

About