Effect of postoperative early ω-3 polyunsaturated fatty acid-based total parenteral nutrition on postoperative complications for patients with Crohn′s disease

Objective To investigate the effect of postoperative early ω-3 polyunsaturated fatty acid-based total parenteral nutrition (TPN) on postoperative complications for patients with Crohn′s disease (CD) . Methods Clinical data of 186 CD patients undergoing intestine resection at Department of General Surgery in our hospital between January 2017 and May 2018 were retrospectively analyzed. The perioperative data and laboratory data were compared between patients with and without ω-3 polyunsaturated fatty acid-based TPN (TPN with ω-3 group and TPN without ω-3 group) . Meanwhile CD patients were divided into two groups: 103 patients in without complications group and 83 patients in with complications group. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for postoperative complications. Results As compared to TPN without ω-3 group, TPN with ω-3 group presented lower postoperative C-reactive protein (CRP) level[ (43.5 ± 3.9) mg/L vs. (57.2 ± 5.3) mg/L, P = 0.047], lower morbidity of overall postoperative complication (24.1% vs. 40.8%, P = 0.016) , lower morbidity of severe complications (9.6% vs. 23.3%, P = 0.014) , shorter postoperative hospital stay[ (9.3 ± 0.6) d vs. (12.1 ± 1.1) d, P = 0.041]. Univariate analysis showed preoperative use of infliximab, TPN with ω-3 polyunsaturated fatty acid, CRP, operative time, and laparoscopic surgery were associated with complications (all P<0.05) . Multivariate analysis revealed that preoperative use of infliximab and postoperative TPN with ω-3 polyunsaturated fatty acid were independent risk factor and protective factor respectively of postoperative complications for CD patients. Conclusion The inflammation ameliorates in CD patient with ω-3 polyunsaturated fatty acid-based TPN after surgery, leading to the decrease of postoperative complications and the acceleration of recovery of patients. Key words: Crohn′s disease; ω-3 polyunsaturated fatty acid; Parenteral nutrition; Postoperative complications