PREOPERATIVE NUTRITION FOR BOWEL RESECTIO N IN CROHN DISEASE

Artificial nutrition prior to bowel resection has not been evaluated f ully. The aim of the present study,vas to assess the effects of preope rative artificial nutrition upon postoperative complications, length o f resected bowel and relapses of Crohn disease. Results. - Between 199 0 and 1994, 108 consecutive patients underwent bowel resection for Cro hn disease. Thirty nine patients had received exclusive enteral nutrit ion (n = 14) or parenteral nutrition (n = 25) for 19 +/- 10 days. Pati ents who had received artificial nutrition were more malnourished and had complicated Crohn disease (fistulae, abscesses) more often than pa tients operated without artificial nutrition. After 19 days of artific ial nutrition, the nutritional state of patients was not significantly improved. Postoperative complication rate was higher in patients oper ated after artificial nutrition (33 vs. 16 %; P = 0.03). Using multiva riate prognosis analysis, the extent of colic resection was significan tly associated with postoperative complications (P = 0.0003). Length o f resected bowel and relapse rates were similar in patients with or wi thout preoperative nutrition. Conclusion. - Artificial nutrition prior to bowel resection for Crohn's disease is indicated in patients with the most severe form of the disease. A preoperative nutrition of 19 da ys does not seem to reduce postoperative complications nor the length of resected bowel.