Autumn Meeting Ulster Society of Gastroenterology, 18th October 2013

Autumn Meeting Ulster Society of Gastroenterology, 18th October 2013 Ramada Hotel, Belfast Smoking knowledge, habitS and uptake of Smoking ceSSation therapieS in patientS attending a tertiary referral centre for inflammatory bowel diSeaSe (ibd) (oral preSentation) Author(s): Hillemand CGP, Lunney PC, Laube RE, Collins GD, Leong RW Department(s)/Institution(s): Gastroenterology and Liver Services, Concord Repatriation General Hospital, Sydney, Australia Aims/Background: Smoking is associated with increased rates of relapse, surgery and use of immunosuppressive therapy in patients with Crohns Disease (CD). We aimed to assess the smoking habits, cessation strategies and knowledge regarding negative associations of smoking on IBD and general health in a cohort of IBD patients. Methods: Data was prospectively collected to assess smoking history, smoking cessation attempts, nicotine dependence and knowledge of smoking in IBD and common smoking related diseases (SRD). Patients with SRD and no history of SRD were used as positive and negative controls respectively. Results: 200 subjects were recruited (100 IBD patients, 100 positive/negative controls). There was significant age difference between IBD group and non-IBD group. Total overall knowledge of smoking causing SRD was 91% in all 3 groups: current smokers, ex-smokers and never smokers. IBD diagnosis did not influence knowledge. Only 57% of CD patients knew smoking was a risk factor for CD. Most patients stopped smoking for general health reasons. 25% of IBD patients stopped to improve their IBD. The most common smoking cessation strategy in all ever smokers was “cold turkey”. There was minimal engagement with Champix, hypnotherapy, behavioural therapies and telephone support (all < 5%). In smokers there was no significant difference in nicotine addiction score between the 3 groups. Conclusion: IBD patients have excellent knowledge of the health risks of smoking. CD patients require further education regarding the negative effects of smoking. Patients prefer “cold turkey”, with low engagement with alternative strategies. Smokers (particularly those with CD) who have failed abstinence previously should engage with a smoking cessation service to improve education and maximise chances of long-term abstinence. the impact of obeSity on mortality and morbidity following liver reSection (oral preSentation) Author(s): Mark DA, Badger SA, Dodd B, McKie LD, Diamond T, Taylor MA Department(s)/Institution(s): Department of Hepatobiliary Surgery, Mater Infirmorum Hospital, Crumlin Road, Belfast, BT14 6AB Aims/Background: Obesity is a risk factor for complications following liver resection. This study aimed to determine the impact of Body Mass Index (BMI) on morbidity and mortality of patients undergoing liver resection. Methods: Patients undergoing liver resection between 2005-2010 inclusive were included. Patients were stratified according to BMI and intra-operative and post-operative courses reviewed. A normal BMI was defined as 18.5-24.9 kg/m2, overweight 25.0-29.9 kg/m2 and obese >30 kg/m2. Kruskal-Wallis and Chi-squared test were used in statistical analysis, with a p value of less than 5% considered significant. Results: 179 patients were included. 57 patients had a normal BMI, 82 were overweight, 37 were obese and 3 were underweight. American Society of Anesthesiologists risk profile grade was equal between groups (p=0.92). An increase in surgical time (p=0.04) and intra-operative blood loss (p=0.01) was seen with increasing BMI. Intra-operative intravenous fluids (p=0.08), inotropic requirements (p=0.82) and transfusion showed no significance (p=0.09). The requirement for a higher level of post-operative care was similar between groups (p=0.15). Conclusions: Obesity has a significant impact on surgical time and intra-operative blood loss but does not alter mortality or overall morbidity in patients undergoing liver resection surgery. Obesity should not prohibit the timely intervention of liver resection when indicated as it is not related to an increased mortality.