Newsletter

[ Vol. 11 No. 2 ] (May - August 2010 )
Characteristics of perioperative nutritional support for crohn disease

Y Koyama, H Nogami, M Yoshizawa, N Manba, M Hasegawa, E Sakata, T Iiai, K Hatakeyama
Division of Digestive & General Surgery, Niigata University Graduate School of Medical & Dental Sciences, Niigata, Japan

RATIONALE
In Crohn disease, most patients with bowel dysfunction and undernutriton need elective nutritional support containing TPN. In the present study, we retrospectively analysed the characteristics of perioperative nutritional support (PNS) for surgical patients with Crohn disease.

METHODS
The surgical patients with Crohn disease at our Hospital during 1998-2006, were entered. The relationship between perioperative nutritional status and nutritional support such as TPN, EN and oral intake (OI) was examined. The patients were also divided according to postoperative complications (PC) or preoperative steroid use (PSu). Perioprerative change of nutritional parameters such as body weight, total protein (TP) and albumin (Alb) were compared. The statistical analysis were performed with Chi square test and Mann-Whiteney U test, and the statistical significance was defined as P<0.05.

RESULTS
Thirty-seven patients with Crohn disease were entered; male/female was 30/7, the mean age was 34.6 years old, preoperative BMI and %IBW was 18.3 and 83.3, respectively, and preoperative nutritional support was performed is 28 patients. PSu was observed in 16 patients, and PC was observed in 20 patients. However, there was no correlation between PC and PSu. However, there was significant difference in the change of TP between with/without postoperative complication. The start day of EN/OI and hospital stay was significantly shorter in the complication negative group.

CONCLUSIONS
In the surgical patients of Crohn disease, TPN is still important procedure for PNS because high risk of PC causes the delay of EN or OI start.

From  
PENSA 2009
“Energizing Nutrition Support Practice for Life”
June 5-7 2009, Shangri-La Hotel, Kuala Lumpur, Malaysia 
Page: 61