Surgical strategies in short bowel syndrome

Abstract

Extensive loss of small bowel in all age groups has significant morbidity and mortality consequences. Despite the astonishing ability of the small bowel to compensate for an extensive loss, long-term parenteral nutrition and enteral nutrition, tailored to the need of the patients in relation to the missing intestinal regions is needed. Organ-preserving surgical intervention becomes necessary in patients with a very short intestinal transit time and in an other group of patients with impaired propulsive peristalsis. Intestinal transplantation is indicated in recurrent septical infections or if nearly all of the small bowel is missing. This review discusses indications and risks of the organ-preserving surgical therapies in children with short bowel syndrome.

Pediatric Intestinal Rehabilitation and Transplantation Registry: Initial Report from a European Collaborative Registry

“…Short bowel syndrome (SBS) is the main cause of IF in the pediatric population, with an estimated incidence of 3 to 5 per 100,000 births per year. 1 SBS is defined as the prolonged need for parenteral nutrition (PN) after extensive bowel resection for congenital or acquired lesions. Recent advances in the multidisciplinary approach including surgical techniques, intensive care, and nutritional support have improved the survival of children with this chronic condition.…”

Case Report of an Adult Patient Who Underwent a Serial Transverse Enteroplasty Procedure for Short Bowel Syndrome Following an Esophagectomy and Total Gastrectomy

“…Short bowel syndrome (SBS) is a disorder characterized by significant malnutrition and malabsorption requiring prolonged parenteral nutrition to prevent dehydration and to replace electrolytes, vitamins, and trace elements, regardless of the remaining bowel length. 1 Although there have been considerable improvements in a multidisciplinary approach and intestinal transplantation to treat SBS over the past two decades, other medical and surgical alternatives remain the main treatment options. The most common surgical alternatives are intestinal lengthening procedures such as the Bianchi procedure and the serial transverse enteroplasty (STEP) procedure.…”

Optimization of In-Continuity Spring-Mediated Intestinal Lengthening

“…This has been shown to reduce the need for parenteral nutrition, but the downside is the high cost of the medication and that it must be administered long-term to maintain its effects [4][5][6][7]. Surgical treatments also exist for SBS, and there are a number of procedures described that can slow bowel transit time [8][9][10][11]. However, none of these procedures create any new intestine, and they only reshape the existing tissue.…”