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A study found that preoperative exclusive enteral nutrition (EEN) in patients with Crohn’s disease undergoing intestinal surgery was associated with a 2.1-fold decrease in the relative risk of intra-abdominal septic complications and a 1.6-fold decrease in the risk of skin and soft tissue infection, suggesting its potential use for optimal outcomes in bowel resection procedures.

The following is a summary of “Preoperative Exclusive Enteral Nutrition Is Associated With Reduced Skin and Soft Tissue and Intra-abdominal Infections in Patients With Crohn’s Disease Undergoing Intestinal Surgery: Results from a Meta-Analysis,” published in the January 2024 issue of Gastroenterology by Krasnovsky et al.

Researchers started a retrospective study to precisely measure how preoperative exclusive enteral nutrition (EEN) and total parenteral nutrition (TPN) affect surgical outcomes in Crohn’s disease (CD) patients undergoing intestinal surgery.

They examined PubMed, Embase, and Scopus to find studies that compared the influence of preoperative nutritional support on postoperative outcomes in patients who had undergone surgery for CD. Pooled risk difference estimates were computed using random effects modeling. The level of heterogeneity was assessed using I².

The results showed 14 nonrandomized cohort studies, meeting inclusion criteria for EEN investigation, demonstrated a 2.1-fold decrease in the relative risk of intra-abdominal septic complications for patients on preoperative EEN (RR 0.47, 95% CI [0.35-0.63], I² = 0.0%; 874 EEN treated and 1044 control patients). In nine studies (638 EEN treated and 819 control patients), the risk of skin and soft tissue infection decreased by 1.6-fold (RR 0.63; 95% CI [0.42-0.94], I² = 42.7%). No significant differences were found in surgery details or infectious outcomes in the 9 TPN studies.

Investigator concluded that preoperative EEN demonstrated lower infection risk in CD patients undergoing intestinal surgery, suggesting its use for optimal outcomes in bowel resection procedures.

Source: academic.oup.com/ibdjournal/advance-article-abstract/doi/10.1093/ibd/izad304/7585830