The role of exclusive enteral nutrition in the preoperative optimization of laparoscopic surgery for patients with Crohn's disease: A cohort study

Ge, Xiaolong; Tang, Shu; Yang, Xiaoyan; Liu, Wei; Ye, Linna; Yu, Weihua; Xu, Haoming; Cao, Qian; Zhou, Wei; Cai, Xiujun

doi:10.1016/j.ijsu.2019.03.012

Cited by 33 publications

(30 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When the PNI is < 40, this surgery may be contraindicated 31 . In other studies, the cutoff value of PNI was 40, which is common, We thus set the cut-off value for the PNI as 40 21,32,33 .…”

Section: Resultsmentioning

confidence: 99%

The pretreatment Controlling Nutritional Status (CONUT) score is an independent prognostic factor in patients undergoing resection for colorectal cancer

Hayama

Ozawa

Okada

et al. 2020

Sci Rep

View full text Add to dashboard Cite

the controlling nutritional Status (conUt) score is a marker of nutrition and is associated with poor survival in various kinds of cancers. However, no reports have yet compared risk factors for colorectal cancer recurrence using a nutritional index. We assessed the predictive value of the conUt score compared with the modified Glasgow Prognostic Score (mGPS) and Prognostic Nutritional Index (pni) in colorectal cancer (cRc) patients. We performed a retrospective cohort study of the medical records of 336 consecutive patients with stage I-I I I CRC who underwent curative resection at a single institution in 2012-2017. Univariate and multivariate analyses were conducted to identify prognostic factors associated with relapse-free survival (RFS) and overall survival (OS). The low CONUT score group exhibited higher RFS and longer OS compared to the high CONUT score group (82.2% vs. 63.3%, p = 0.002 and 95.5% and 86.2%, p = 0.005, respectively). The Akaike's information criterion values of each index for RFS and OS were superior in CONUT score (723.71 and 315.46, respectively) compared to those of PNI (726.95 and 316.52) and mGPS (728.15 and 318.07, respectively). The conUt score was found to be a good predictor of RfS and oS in patients with resectable cRc. Abbreviations AIC Akaike's information criterion AJCC American Joint Committee on Cancer CA19-9 Carbohydrate antigen 19-9 CEA Carcinoembryonic antigen CONUT Controlling Nutritional Status CRC Colorectal cancer CRP C-reactive protein mGPS modified Glasgow Prognostic Score OS Overall survival PNI Prognostic nutritional index RFS Relapse-free survival Colorectal cancer (CRC), one of the most common and aggressive malignancies, is the fourth-leading cause of cancer-related death worldwide 1. The Controlling Nutritional Status (CONUT) score-which is comprised of the serum values of albumin (ALB) , total lymphocyte count (TLC), and total cholesterol-is considered a potential predictor of poor outcomes in several types of malignances, including colorectal cancer 2,3. Two nutritional

show abstract

Section: Resultsmentioning

confidence: 99%

The pretreatment Controlling Nutritional Status (CONUT) score is an independent prognostic factor in patients undergoing resection for colorectal cancer

Hayama

Ozawa

Okada

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…They showed a decreased risk of IASC and in the duration of post-operative hospitalisation in the EEN group. Ge et al [173] compared semi-elemental EEN with general ONS in patients undergoing laparoscopic surgery finding reduced surgical site infections but not a significant difference in intra-abdominal septic complications.…”

Section: Role Of En In the Perioperative Settingmentioning

confidence: 99%

Enteral Nutrition in Adult Crohn’s Disease: Toward a Paradigm Shift

Fragkos

Keetarut

et al. 2019

Nutrients

View full text Add to dashboard Cite

Medical and surgical treatments for Crohn’s disease are associated with toxic effects. Medical therapy aims for mucosal healing and is achievable with biologics, immunosuppressive therapy, and specialised enteral nutrition, but not with corticosteroids. Sustained remission remains a therapeutic challenge. Enteral nutrition, containing macro- and micro-nutrients, is nutritionally complete, and is provided in powder or liquid form. Enteral nutrition is a low-risk and minimally invasive therapy. It is well-established and recommended as first line induction therapy in paediatric Crohn’s disease with remission rates of up to 80%. Other than in Japan, enteral nutrition is not routinely used in the adult population among Western countries, mainly due to unpalatable formulations which lead to poor compliance. This study aims to offer a comprehensive review of available enteral nutrition formulations and the literature supporting the use and mechanisms of action of enteral nutrition in adult Crohn’s disease patients, in order to support clinicians in real world decision-making when offering/accepting treatment. The mechanisms of actions of enteral feed, including their impact on the gut microbiome, were explored. Barriers to the use of enteral nutrition, such as compliance and the route of administration, were considered. All available enteral preparations have been comprehensively described as a practical guide for clinical use. Likewise, guidelines are reported and discussed.

show abstract

“…These findings clearly demonstrated that preoperative ALI is a useful prognostic marker in CD patients, and quantification of preoperative ALI might help physicians to identify CD patients at high risk of surgical relapse and who will probably require close follow‐up with individualized medical treatment. A previous study demonstrated that preoperative nutrition intervention, including enteral nutrition, could reduce postoperative surgical and endoscopic recurrence rates after intestinal resection in CD patients [9,10,37]. In this study, several nutritional markers could predict postoperative surgical recurrence with relatively high accuracy for CD patients and preoperative ALI showed the highest accuracy for prediction of postoperative surgical recurrence compared to other nutrition markers.…”

Section: Discussionmentioning

confidence: 65%

The advanced lung cancer inflammation index predicts outcomes in patients with Crohn’s disease after surgical resection

et al. 2020

View full text Add to dashboard Cite

Aim Precise biomarkers for predicting prognosis could help to identify high‐risk Crohn's disease (CD) patients to facilitate better follow‐up during the postoperative course. In this study, the primary aim is the identification of the most reliable nutrition marker that predicts surgical relapse in CD patients. Method We first evaluated the predictive value of various nutrition markers for postoperative surgical relapse in CD patients and identified the advanced lung cancer inflammation index (ALI) as a promising biomarker. Then, we assessed the clinical significance of preoperative ALI in CD patients using two cohorts. Results Preoperative ALI showed the highest correlation with reoperation rate compared with other nutritional parameters in CD patients receiving surgical resection (sensitivity 53%, specificity 86%, area under the curve 0.71). Lower levels of preoperative ALI were significantly correlated with the presence of perianal disease. A lower level of preoperative ALI was an independent prognostic factor for reoperation rate after an intestinal resection (hazard ratio 3.37, 95% CI 1.38–10.12, P = 0.006), and the prognostic impact of preoperative ALI was successfully validated in an independent cohort using the same cut‐off value. Conclusion Preoperative ALI might be useful for postoperative management of CD patients.

show abstract

The role of exclusive enteral nutrition in the preoperative optimization of laparoscopic surgery for patients with Crohn's disease: A cohort study

Cited by 33 publications

References 31 publications

The pretreatment Controlling Nutritional Status (CONUT) score is an independent prognostic factor in patients undergoing resection for colorectal cancer

The pretreatment Controlling Nutritional Status (CONUT) score is an independent prognostic factor in patients undergoing resection for colorectal cancer

Enteral Nutrition in Adult Crohn’s Disease: Toward a Paradigm Shift

The advanced lung cancer inflammation index predicts outcomes in patients with Crohn’s disease after surgical resection

Contact Info

Product

Resources

About