Preoperative screening and prehabilitation strategies prior to ileocolic resection in patients with Crohn’s disease are not incorporated in routine care

Michiel Thomas Jan Bak, Oddeke van Ruler, Laurents Stassen, Marit Ruiterkamp, Jeanine Hubertina Catharina Arkenbosch, Gerard Dijkstra, Maria Johanna Elisabeth Campmans-Kuijpers, Nico Leonard Ulrich van Meeteren, Bart Chateau Bongers, Mariëlle Romberg-Camps, Sander van der Marel, Frank Hoentjen, Koen Willem van Dongen, Rachel West, Janneke van der Woude, Annemarie Charlotte de Vries*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)
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Abstract

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.

Original languageEnglish
Article number254
JournalInternational Journal of Colorectal Disease
Volume38
Issue number1
DOIs
Publication statusPublished - 19 Oct 2023

Bibliographical note

Publisher Copyright:
© 2023, The Author(s).

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