Preoperative Nutritional Conditioning of Crohn's Patients-Systematic Review of Current Evidence and Practice.

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Ressource 1Download: nutrients-09-00562.pdf (937.12 [Ko])
State: Public
Version: author
Serval ID
serval:BIB_DBA971965332
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Preoperative Nutritional Conditioning of Crohn's Patients-Systematic Review of Current Evidence and Practice.
Journal
Nutrients
Author(s)
Grass F., Pache B., Martin D., Hahnloser D., Demartines N., Hübner M.
ISSN
2072-6643 (Electronic)
ISSN-L
2072-6643
Publication state
Published
Issued date
01/06/2017
Peer-reviewed
Oui
Volume
9
Number
6
Pages
NA
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: epublish
Abstract
Crohn's disease is an incurable and frequently progressive entity with major impact on affected patients. Up to half of patients require surgery in the first 10 years after diagnosis and over 75% of operated patients require at least one further surgery within lifetime. In order to minimize surgical risk, modifiable risk factors such as nutritional status need to be optimized. This systematic review on preoperative nutritional support in adult Crohn's patients between 1997 and 2017 aimed to provide an overview on target populations, screening modalities, routes of administration, and expected benefits. Pertinent study characteristics (prospective vs. retrospective, sample size, control group, limitations) were defined a priori. Twenty-nine studies were retained, of which 14 original studies (9 retrospective, 4 prospective, and 1 randomized controlled trial) and 15 reviews. Study heterogeneity was high regarding nutritional regimens and outcome, and meta-analysis could not be performed. Most studies were conducted without matched control group and thus provide modest level of evidence. Consistently, malnutrition was found to be a major risk factor for postoperative complications, and both enteral and parenteral routes were efficient in decreasing postoperative morbidity. Current guidelines for nutrition in general surgery apply also to Crohn's patients. The route of administration should be chosen according to disease presentation and patients' condition. Further studies are needed to strengthen the evidence.

Keywords
Crohn Disease/therapy, Humans, Meta-Analysis as Topic, Morbidity, Nutrition Assessment, Nutrition Policy, Nutritional Support, Perioperative Care, Postoperative Complications/epidemiology, Postoperative Complications/prevention & control, Preoperative Care, Randomized Controlled Trials as Topic, Risk Factors, Treatment Outcome, Crohn’s, complications, inflammatory bowel disease, nutrition, preoperative, supplement, surgery
Pubmed
Web of science
Open Access
Yes
Create date
13/06/2017 18:26
Last modification date
20/08/2019 16:00
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