Abstract Background Exclusive enteral nutrition (EEN) is a well-established first-line treatment for inducing remission in pediatric Crohn’s disease. However, its use in the treatment of adult Crohn’s disease remains limited. In adults, 22% of patients require surgery within the first five years after diagnosis1, with postoperative complication rates reaching around 25%2. This study investigates whether preoperative EEN can reduce postoperative complications in adults with Crohn’s disease undergoing elective surgery. Methods A systematic search was conducted on October 26, 2024, across three databases: PubMed, EMBASE, and the Cochrane Library. Studies were included if they involved at least two weeks of preoperative EEN and reported postoperative outcomes. The primary outcomes were anastomotic leakage, stoma formation, and abscess formation, while the secondary outcome was the length of hospital stay. The odds ratio (OR) and mean differences (MD) with their 95% confidence interval (CI) were calculated using a random-effect model. Results A total of 11 studies, including 2112 patients, were included in the analysis. EEN significantly reduced the odds of anastomotic leakage (OR = 0.29, CI: 0.19-0.47), stoma formation (OR = 0.39, CI: 0.09-1.73), abscess formation (OR = 0.41, CI: 0.23-0.72), and endoscopic recurrence in six months (OR = 0.36, CI: 0.04-3.24). Conclusion Preoperative EEN significantly reduces the risk of anastomotic leakage, stoma formation, abscess formation, and endoscopic recurrence at six months, leading to improved postoperative outcomes. These findings support adding EEN into preoperative management for adult Crohn’s disease patients undergoing elective surgery to enhance recovery and minimize complications. References: 1. Burisch, J., et al.,(2019). Natural disease course of Crohn’s disease during the first5 years after diagnosis in a European population-based inception cohort: an Epi-IBD study. Gut, 68(3), 423–433. https://doi.org/10.1136/gutjnl-2017-315568 2. Luglio, G., et al.,(2022). Post-operative morbidity in Crohn’s disease: what is the impact of patient-, disease- and surgery-related factors?. International journal of colorectal disease, 37(2), 411–419. https://doi.org/10.1007/s00384-021-04076-5 Conflict of interest: Mrs. Demeter, Dóra: No conflict of interest Kollányi, Gergely: No conflict of interest Makolli, Amir: No conflict of interest Obeidat, Mahmoud: No conflict of interest Yoshida, Ayano: No conflict of interest Hegyi, Péter: No conflict of interest Golovics, Petra: No conflict of interest Gyökeres, Tibor Zoltán: No conflict of interest
Demeter et al. (Thu,) studied this question.