O017 - PREOPERATIVE EXCLUSIVE ENTERAL NUTRITION REDUCES POSTOPERATIVE COMPLICATIONS IN ADULTS WITH CROHN’S DISEASE UNDERGOING ELECTIVE SURGERY: A SYSTEMATIC REVIEW AND META-ANALYSIS

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O017

PREOPERATIVE EXCLUSIVE ENTERAL NUTRITION REDUCES POSTOPERATIVE COMPLICATIONS IN ADULTS WITH CROHN’S DISEASE UNDERGOING ELECTIVE SURGERY: A SYSTEMATIC REVIEW AND META-ANALYSIS

D. Demeter1,2,*, G. Kollányi1,3, A. Makolli1,4,5, M. Obeidat1, A. Yoshida1, P. Hegyi1,6,7, P. A. Golovics1,2, T. Gyökeres1,2

1Centre for Translational Medicine, Semmelweis University, 2Department of Gastroenterology, Central Hospital of Northern Pest-Military Hospital, 3Department of Gastroenterology, St. Imre Teaching Hospital, 4Department of Pharmacology and Pharmacotherapy, 5Center for Pharmacology and Drug Research & Development, 66. Institute of Pancreatic Diseases, Semmelweis University, Budapest, 77.   Institute for Translational Medicine, University of Pécs, Pécs, Hungary

 

Rationale: Exclusive enteral nutritions (EEN) use in adult Crohn’s disease (CD) treatment remains limited. 22% of adult CD patients require surgery within the first five years after diagnosis, with postoperative complication rates reaching around 25%1. This study investigates whether preoperative EEN can reduce postoperative complications in adults with CD undergoing elective surgery.

Methods: A systematic search was conducted on October 26, 2024, across three databases:PubMed, EMBASE, and the Cochrane Library. Studies were included if they involved at least two weeks of preoperative EEN and reported postoperative outcomes. The primary outcomes were anastomotic leakage, stoma formation and abscess formation, while the secondary outcome was the length of hospital stay. The odds ratio (OR) and mean differences (MD) with their 95% confidence interval (CI) were calculated using a random-effect model.

Results: A total of 11 studies, including 2112 patients, were included in the analysis. EEN significantly reduced the odds of anastomotic leakage (OR=0.29, CI: 0.19-0.47), stoma formation (OR=0.39, CI: 0.09-1.73), and abscess formation (OR=0.41, CI: 0.23-0.72). However, there was no significant reduction in the length of hospital stay (MD: 0.88 days, CI: -1.85-0.09).

Conclusion: Preoperative EEN significantly reduces the risk of anastomotic leakage, stoma formation, and abscess formation, leading to improved postoperative outcomes. These findings support adding EEN into preoperative management for adult Crohn’s disease patients undergoing elective surgery to enhance recovery and minimize complications.

References: Luglio, G.,  et al.,(2022). Post-operative morbidity in Crohn's disease: what is the impact of patient-, disease- and surgery-related factors?. International journal of colorectal disease, 37(2), 411–419. https://doi.org/10.1007/s00384-021-04076-5

Disclosure of Interest: None declared