Perioperative parenteral fish oil supplementation improves postoperative coagulation function and outcomes in patients undergoing colectomy for ulcerative colitis.

OBJECTIVE Ulcerative colitis (UC) is an independent risk factor for thromboembolism, especially during the perioperative period. This study aimed to determine the effects of perioperative total parenteral nutrition (TPN) supplemented with fish oil on coagulation function and postoperative outcomes in patients with UC. METHODS This retrospective cohort included 92 consecutive patients who underwent colectomy for UC. Postoperative coagulation indices and outcomes, including thromboelastography (TEG) findings and comprehensive complication index (CCI), were compared. The relative change in serum D-dimer (ΔD-dimer) levels and maximal amplitude (ΔMA) on TEG were also determined. RESULTS Patients receiving TPN supplemented with fish oil (n = 48) had lower D-dimer (3.19±0.28 vs. 4.51±0.54 mg/L, p = 0.036) levels on postoperative day (POD) 5 and a higher MA (68.18±2.19 vs. 54.24±1.83 mm, p<0.001) on POD 1 than who did not receive it (n = 44). A lower ΔD-dimer level (0.80±0.38 vs. 2.15±0.56 mg/L, p = 0.048) and ΔMA (0.9 vs. 13.2 mm, p<0.001) were also observed in patients receiving fish oil. The incidence of major postoperative complications (6.3 vs. 22.7%, p = 0.017) and CCI (20.9 vs. 23.4%, p = 0.044) were significantly lower in patients receiving fish oil. In multivariate analysis, fish oil (odds ratio, 0.231; 95% confidence interval, 0.055-0.971; p = 0.046) was a positive protector of major postoperative complications. CONCLUSION Perioperative TPN supplemented with fish oil improved coagulation function and reduced major postoperative complications in patients with UC requiring colectomy. These results may provide cues in formulating management strategies for preventing thromboembolisms and postoperative complications in patients with UC. This article is protected by copyright. All rights reserved.