TY - JOUR
T1 - Preoperative screening and prehabilitation strategies prior to ileocolic resection in patients with Crohn’s disease are not incorporated in routine care
AU - Bak, Michiel Thomas Jan
AU - van Ruler, Oddeke
AU - Stassen, Laurents
AU - Ruiterkamp, Marit
AU - Arkenbosch, Jeanine Hubertina Catharina
AU - Dijkstra, Gerard
AU - Campmans-Kuijpers, Maria Johanna Elisabeth
AU - van Meeteren, Nico Leonard Ulrich
AU - Bongers, Bart Chateau
AU - Romberg-Camps, Mariëlle
AU - van der Marel, Sander
AU - Hoentjen, Frank
AU - van Dongen, Koen Willem
AU - West, Rachel
AU - van der Woude, Janneke
AU - de Vries, Annemarie Charlotte
N1 - Funding Information:
We want to thank Lisa Siegal, native speaker, for the critical revision of our manuscript.
Publisher Copyright:
© 2023, The Author(s).
PY - 2023/10/19
Y1 - 2023/10/19
N2 - Purpose: Recently, recommendations on perioperative care have been published to optimize postoperative outcomes in preoperative patients with inflammatory bowel disease. This study evaluated the current use of preoperative screening and prehabilitation strategies (PS) prior to elective ileocolic resection (ICR) in patients with Crohn’s disease (CD). Methods: Patients with CD who underwent an elective ICR were identified from a Dutch prospective cohort study. Primary endpoint was to evaluate to what extent IBD-relevant PS were applied in patients with CD prior to ICR according to the current recommendations. Results: In total, 109 CD patients were included. Screening of nutritional status was performed in 56% of the patients and revealed malnutrition in 46% of these patients. Of the malnourished patients, 46% was referred to a dietitian. Active smoking and alcohol consumption were reported in 20% and 28%; none of these patients were referred for a cessation program. A preoperative anemia was diagnosed in 61%, and ferritin levels were assessed in 26% of these patients. Iron therapy was started in 25% of the patients with an iron deficiency anemia. Exposure to corticosteroids at time of ICR was reported in 29% and weaned off in 3%. Consultation of a dietitian, psychologist, and physiotherapist was reported in 36%, 7%, and 3%. Physical fitness was assessed in none of the patients. Conclusion: PS are not routinely applied and not individually tailored in the preoperative setting prior to elective ICR in patients with CD. Prior to implementation, future research on the costs and effectiveness of PS on postoperative outcomes and quality of life is necessary.
AB - Purpose: Recently, recommendations on perioperative care have been published to optimize postoperative outcomes in preoperative patients with inflammatory bowel disease. This study evaluated the current use of preoperative screening and prehabilitation strategies (PS) prior to elective ileocolic resection (ICR) in patients with Crohn’s disease (CD). Methods: Patients with CD who underwent an elective ICR were identified from a Dutch prospective cohort study. Primary endpoint was to evaluate to what extent IBD-relevant PS were applied in patients with CD prior to ICR according to the current recommendations. Results: In total, 109 CD patients were included. Screening of nutritional status was performed in 56% of the patients and revealed malnutrition in 46% of these patients. Of the malnourished patients, 46% was referred to a dietitian. Active smoking and alcohol consumption were reported in 20% and 28%; none of these patients were referred for a cessation program. A preoperative anemia was diagnosed in 61%, and ferritin levels were assessed in 26% of these patients. Iron therapy was started in 25% of the patients with an iron deficiency anemia. Exposure to corticosteroids at time of ICR was reported in 29% and weaned off in 3%. Consultation of a dietitian, psychologist, and physiotherapist was reported in 36%, 7%, and 3%. Physical fitness was assessed in none of the patients. Conclusion: PS are not routinely applied and not individually tailored in the preoperative setting prior to elective ICR in patients with CD. Prior to implementation, future research on the costs and effectiveness of PS on postoperative outcomes and quality of life is necessary.
KW - Crohn’s disease
KW - Ileocolic (re-)resection
KW - Prehabilitation
KW - Preoperative optimization
U2 - 10.1007/s00384-023-04537-z
DO - 10.1007/s00384-023-04537-z
M3 - Article
SN - 0179-1958
VL - 38
JO - International Journal of Colorectal Disease
JF - International Journal of Colorectal Disease
IS - 1
M1 - 254
ER -