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Prehabilitation: The Impact of Preoperative Exclusive Enteral Nutrition on Paediatric Patients With Crohn Disease

Rachel E Harris1, Hazel Duncan1, Elaine Buchanan1

  • 1Department of Paediatric Gastroenterology, Hepatology and Nutrition.

Journal of Pediatric Gastroenterology and Nutrition
|December 28, 2019
PubMed

Insights

Exclusive enteral nutrition (EEN) is achievable before surgery in pediatric Crohn disease (CD) patients. Preoperative EEN was linked to less severe inflammation at resection, suggesting potential peri-operative benefits.

Area of Science:

  • Pediatric Gastroenterology
  • Surgical Nutrition
  • Inflammatory Bowel Disease

Background:

  • Exclusive enteral nutrition (EEN) effectively induces remission in pediatric Crohn disease (CD).
  • EEN has demonstrated anti-inflammatory effects and improved outcomes in adult CD patients undergoing surgery.

Purpose of the Study:

  • To assess the feasibility and peri-operative outcomes of preoperative EEN in pediatric CD patients undergoing right hemicolectomy.

Main Methods:

  • Retrospective study including 17 pediatric CD patients undergoing right hemicolectomy.
  • Eight patients received preoperative EEN (oral, nasogastric tube, or gastrostomy), while 9 did not.
  • Disease severity at resection was evaluated based on pathology reports.

Main Results:

  • Preoperative EEN was successfully administered to 8 patients.
  • Patients receiving preoperative EEN showed a significantly lower rate of moderate/severe disease on resection pathology (62.5% vs 100%, P=0.04).

Conclusions:

  • Preoperative EEN is a feasible intervention in pediatric CD patients undergoing right hemicolectomy.
  • EEN is associated with reduced disease severity at the time of surgery.
  • Larger studies are needed to confirm the impact of preoperative EEN on postoperative outcomes in pediatric CD.

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