The impact of preoperative total parenteral nutrition on the surgical complications of Crohn's disease: A retrospective cohort study
Thamer A Bin Traiki1, Sulaiman A Alshammari1, Nadia A Aljomah2, Monirah M Alsalouli2, Esraa S Altawil3, Maha-Hamadien Abdulla1, Noura S Alhassan1, Khayal A Alkhayal1
1 Department of Surgery, Colorectal Research Chair, College of Medicine, King Saud University, Riyadh, Saudi Arabia
2 Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
3 Pharmacy Department, Clinical Pharmacy Services, King Saud University Medical City, Riyadh, Saudi Arabia
Sulaiman A Alshammari,
Colorectal Research Chair, Department of Surgery, College of Medicine, King Saud University, Riyadh - 11461
Source of Support: None, Conflict of Interest: None
Background: Crohn's disease (CD) is associated with malnutrition, an independent risk factor for surgical morbidity and mortality in more than 65% of patients, with a significant impact on disease outcomes. In this single-center retrospective cohort study, we aimed to investigate the impact of total parenteral nutrition (TPN) on the surgical outcomes of patients with CD.
Methods: This study included patients with CD who underwent abdominal surgery. We compared patients who received preoperative total parenteral nutrition (TPN group) to those who did not (non-TPN group). Prolonged oral intolerance, albumin level <30 g/L, and body mass index <18.5 were the main indications for TPN. We evaluated postoperative surgical complications in both groups.
Results: Between January 2010 and October 2018, 169 eligible patients underwent abdominal surgery. The TPN and non-TPN groups included 40 and 129 patients, respectively. The mean albumin level was significantly lower in the TPN group (P = 0.013). Laparoscopic surgery was performed in 76.9% of the patients, with a conversion rate of 11.6%. Infectious and non-infectious complications developed in 8.9% and 16% of patients, respectively. Surgical complications were comparable between the groups (P >0.05).
Conclusions: Despite oral intake intolerance and severe disease in the TPN group, the surgical complications were comparable between the groups.