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Intestinal Rehabilitation And Bowel Reconstructive Surgery: Improved Outcomes In Children With Short Bowel Syndrome.
MedLine Citation:
PMID:  21832945     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: Short bowel syndrome poses a great challenge to paediatric teams. Several innovative techniques in the management of total parenteral nutrition and bowel reconstructive surgery have improved the outcomes of these children. The authors present their experience as a specialist unit over the last decade using improved techniques and multidisciplinary approaches in the management of this condition. METHODS:: All children presenting with short bowel syndrome in the period 2000 - 2009 were identified. Diagnosis, length of residual gut, age at definitive surgery, length of gut pre-lengthening, length of gut post lengthening, total parenteral nutrition (TPN) status and survival were recorded. Median values were calculated. RESULTS:: Twenty seven children were identified (14 M: 13F). Overall survival was 92%. Two children died. Nineteen children required bowel lengthening whilst 8 children had simple bowel reconstruction whilst on our protocol. Overall median age at definitive surgery was 12months. Overall Median residual gut length for these was 35.5 cm whilst the median residual gut length for patients undergoing bowel lengthening was 25 cm. Post bowel lengthening, median gut length was 90 cm. TPN data was unavailable for 2 patients. Overall, excluding the 2 patients that died and the 2 we have no TPN data on, out of 23 patients, 21 (91%) are now off TPN. CONCLUSION:: Our series show improved results not only with survival but also in the number of patients that are off total parenteral nutrition. Multidisciplinary approach consisting of both medical and surgical expertise is necessary in the management of these patients. The authors advocate centralization of short gut services to experienced centers with multidisciplinary expertise.
Authors:
Basem A Khalil; Muhammad E Ba'ath; Anuar Aziz; Lynette Forsythe; Sara Gozzini; Fiona Murphy; Gordon Carlson; Adrian Bianchi; Antonino Morabito
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-8
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  -     ISSN:  1536-4801     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
* Department of Paediatric Surgery, Royal Manchester Children's Hospital, Oxford Road, Manchester, UK, M13 9WL † Professor of Surgery, Adult Intestinal Failure Unit, Hope Hospital, Manchester, UK.
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