Role of perioperative parenteral nutrition in severely malnourished patients with Crohn's disease.
OBJECTIVE
To evaluate the effect of perioperative parenteral nutrition on serum immunoglobulin, weight change, and post-operative outcome in severely malnourished patients with Crohn's disease.


METHODS
Thirty-two severely malnourished patients with Crohn's disease who had undergone surgery in our hospital were reviewed. Sixteen patients who received perioperative parenteral nutrition were enrolled in the study group, and the other 16 patients who did not receive parenteral nutrition were enrolled in the control group. Serum immunoglobulin, body mass index (BMI), liver function, weight change, and postoperative complications were evaluated.


RESULTS
Serum IgM levels elevated 1 wk before surgery in both groups, and decreased to normal value (from 139+/-41 to 105+/-29 mg/dL, P = 0.04) 4 wk after operation in the study group, while no significant changes was noted in the control group (from 133+/-16 to 129+/-13 mg/dL, P = 0.34). There were no significant changes in concentrations of IgG and IgA. The BMI of the study group increased from 13.9+/-0.6 to 15.3+/-0.7 kg/m(2) (P = 0.02) with no significant change in the control group (14.1+/-0.7 and 14.5+/-0.5, respectively, P = 0.81). The percentage of resuming work was higher in the study group than in the control group.


CONCLUSIONS
Perioperative parenteral nutrition possibly ameliorates the humoral immunity, reverses malnutrition, and facilitates rehabilitation.
Yao
Guo-Xiang
GX
Department of Surgery, New Surg Bld-14 F, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095# Jiefang Grand Road, Wuhan 430030, Hubei Province, China. gxyao@tjh.tjmu.edu.cn
Wang
Xiu-Rong
XR
Jiang
Zhu-Ming
ZM
Zhang
Si-Yuang
SY
Ni
An-Ping
AP
D003424:Crohn Disease / Q000150:complications*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D044342:Malnutrition / Q000150:complications* / Q000178:diet therapy*; D010288:Parenteral Nutrition; D019990:Perioperative Care; D015430:Weight Gain
D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M