P448 - MEASURED RESTING ENERGY EXPENDITURE IN A COHORT OF ULCERATIVE COLITIS PATIENTS UNDERGOING RECONSTRUCTIVE COLECTOMY WITH ILEOANAL J-POUCH ANASTOMOSIS.

P448

MEASURED RESTING ENERGY EXPENDITURE IN A COHORT OF ULCERATIVE COLITIS PATIENTS UNDERGOING RECONSTRUCTIVE COLECTOMY WITH ILEOANAL J-POUCH ANASTOMOSIS.

A. Papadopoulou¹, D. Karayiannis^1,*, A. Almperti¹, S. Kakavas², D. Manganas³

¹Clinical Nutrition, Evaggelismos General Hospital, ²Intensive Care Unit, Henry Dynant, ³2nd Department of Surgery, Evaggelismos General Hospital, Athens, Greece

Rationale: Total colectomy with ileoanal J-pouch anastomosis (IPAA) is the surgical treatment of choice for drug-resistant Ulcerative Colitis (UC). The physiological changes across the three surgical stages highlight the need to accurately determine patients' energy requirements to maintain their nutritional status. This pilot study aims to assess the energy expenditure of UC patients undergoing total colectomy with IPAA using indirect calorimetry (IC) and compare it with estimated energy requirements. 

Methods: A cross sectional analysis of adult UC patients undergoing surgery at “Evangelismos General Hospital of Athens” from September 2023 to December 2024. Resting Energy Expenditure (REE) was measured using IC. Patients' gastrointestinal function, anthropometric data, and biochemical markers were recorded postoperatively. Agreement between measured and estimated energy requirements was determined using Bland-Altman plots.

Results: Among 24 patients enrolled (mean age= 48 ± 16, 79% female) REE measurements suggest a gradual decrease of energy requirements across the three surgical stages (from 1962 kcal/day to 1841 kcal/day and 1767 kcal/day across stages 1, 2 and 3, respectively, p<0.001]. Furthermore, the deviation between estimated and measured energy expenditure was statistically significant in the first (Mean Difference (MD)= 286 kcal, 95% CI: 119, 453) and second (MD= 220 kcal, 95% CI: 57, 384) surgical stages, but not in the third stage (MD= 139 kcal, 95% CI: -6, 283). 

Conclusion: Ulcerative colitis patients undergoing IPAA exhibit a decrease in energy expenditure across surgical stages. Discrepancies between measured and estimated energy needs were significant in early stages, highlighting the need for personalized nutritional management to optimize patient outcomes.

Disclosure of Interest: None declared