Abstract：
Achieving optimal nutritional status in patients with penetrating Crohn\'s disease is crucial in preparing for surgical resection. However, there is a dearth of literature comparing the efficacy of total parenteral nutrition (TPN) v. exclusive enteral nutrition (EEN) in optimising postoperative outcomes. Hence, we conducted a case-matched study to assess the impact of preoperative EEN v. TPN on the incidence of postoperative adverse outcomes, encompassing overall postoperative morbidity and stoma formation, among penetrating Crohn\'s disease patients undergoing bowel surgery. From 1 December 2012 to 1 December 2021, a retrospective study was conducted at a tertiary centre to enrol consecutive patients with penetrating Crohn\'s disease who underwent surgical resection. Propensity score matching was utilised to compare the incidence of postoperative adverse outcomes. Furthermore, univariate and multivariate logistic regression analyses were conducted to identify the risk factors associated with adverse outcomes. The study included 510 patients meeting the criteria. Among them, 101 patients in the TPN group showed significant improvements in laboratory indicators at the time of surgery compared with pre-optimisation levels. After matching, TPN increased the occurrence of postoperative adverse outcomes (92·2 % v. 64·1 %, P = 0·001) when compared with the EEN group. In the multivariate analysis, TPN showed a significantly higher OR for adverse outcomes than EEN (OR = 4·241; 95 % CI 1·567-11·478; P = 0·004). The study revealed that penetrating Crohn\'s disease patients who were able to fulfil their nutritional requirements through EEN exhibited superior nutritional and surgical outcomes in comparison with those who received TPN.
摘要：
穿透性克罗恩病（CD）患者的最佳营养状况对于准备手术切除至关重要。然而,缺乏文献比较全胃肠外营养(TPN)与专有肠内营养(EEN)在优化术后结局方面的疗效.因此，我们进行了一项病例匹配研究，以评估术前EEN与TPN对术后不良结局发生率的影响，包括术后总体发病率和造口形成，穿透性CD患者接受肠道手术。从2012年12月1日至2021年12月1日，在三级中心进行了一项回顾性研究，以招募连续接受手术切除的穿透性CD患者。使用倾向评分匹配（PSM）来比较术后不良结局的发生率。此外，我们进行了单因素和多因素logistic回归分析,以确定与不良结局相关的危险因素.该研究包括510名符合标准的患者。其中,与优化前的水平相比，TPN组的101例患者在手术时的实验室指标显着改善。匹配后,TPN术后不良结局发生率增加(92.2%vs.64.1%,与EEN组相比，p=0.001）。在多变量分析中，TPN的不良结局比值比显著高于EEN（OR=4.241；95%CI1.567-11.478；p=0.004）。研究表明，与接受TPN的患者相比，能够通过EEN满足营养需求的穿透性CD患者表现出更好的营养和手术结果。
