PDF(Pubmed)
Abstract：
Preoperative exclusive enteral nutrition (EEN) improves nutritional status, reduces intestinal inflammation, and likely improves surgical outcomes. Crohn\'s disease exclusion diet with partial enteral nutrition (CDED) also reduces intestinal inflammation but its safety preoperatively is unknown. This single-blinded, multicentre, randomised controlled trial of three preoperative nutritional therapies aimed to assess the feasibility of recruiting and retaining patients and collecting primary and secondary effectiveness outcomes. Adults undergoing elective Crohn\'s disease surgery with a body mass index (BMI) > 18.5 kg/m2 and without significant weight loss were eligible to participate. Patients were randomly assigned to six weeks of preoperative EEN, CDED, or standard care. Feasibility, nutritional, radiological, and surgical outcomes were recorded. Over 18 months, 48 patients were screened, 17 (35%) were randomised, and 13/17 (76%) patients were retained in the intervention phase. It was feasible to collect primary and secondary effectiveness data; at day 30, three patients had Clavien Dindo Grade 2 complications, and 10 had no complications. Nutritional therapy adherence of patients retained in the study was high. Recruitment and retention of patients who need elective Crohn\'s disease surgery for preoperative nutritional therapy is possible, although a shorter duration may improve EEN completion. The impact on surgical outcomes should be assessed in a larger study.
摘要：
术前独家肠内营养（EEN）改善营养状况，减少肠道炎症，并可能改善手术结果。克罗恩病排除饮食和部分肠内营养（CDED）也可以减少肠道炎症，但其安全性尚不清楚。这个单盲，多中心,3项术前营养治疗的随机对照试验旨在评估招募和保留患者以及收集主要和次要疗效结局的可行性.接受选择性克罗恩病手术且体重指数（BMI）>18.5kg/m2且无明显体重减轻的成年人有资格参加。患者被随机分配到6周的术前EEN，CDED,或标准护理。可行性,营养,放射学,并记录手术结果.超过18个月,对48例患者进行了筛查，17人（35%）被随机分组，13/17(76%)患者保留在干预阶段.收集主要和次要有效性数据是可行的；在第30天，三名患者出现ClavienDindo2级并发症，10人无并发症。研究中保留的患者的营养治疗依从性很高。招募和保留需要选择性克罗恩病手术进行术前营养治疗的患者是可能的，虽然较短的持续时间可以提高EEN完成。应在更大的研究中评估对手术结果的影响。
