Summary
Two categories of surgical interventions, other than small bowel transplant, that are used in patients with short bowel syndrome, are: procedures that increase the absorptive surface and procedures that improve remnant function. The appraisal of the evidence in this field is hampered by methodological flaws, like the inaccuracy of measurement of bowel length; lack of prospective comparative studies and inconsistent use of outcome parameters. This paper reviews the indications and results of various interventions. The recommendations are made into an algorithm, as an aid in the decision-making process.
Samenvatting
De chirurgische interventies, anders dan darmtransplantatie, die worden toegepast bij het kortedarmsyndroom, kunnen worden ingedeeld in twee categorieën: procedures die het resorberend oppervlak vergroten en procedures die de resterende darmfunctie verbeteren. De beoordeling van de literatuur op dit terrein wordt bemoeilijkt door methodologische problemen: er bestaan geen prospectieve vergelijkende onderzoeken; lengtemeting van de darm is onnauwkeurig, maar er is geen alternatief; er worden veel verschillende uitkomstparameters gebruikt. In dit artikel worden de indicaties en resultaten van een aantal chirurgische interventies besproken. De aanbevelingen worden in een algoritme verwerkt, dat kan helpen bij het nemen van besluiten.
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Prof.dr. H.A. Heij, kinderchirurg, Kinderchirurgisch Centrum Amsterdam, vu Medisch Centrum en Emma Kinderziekenhuis/amc, Amsterdam. Dr. R.S.V.M. Severijnen, kinderchirurg, umc St Radboud, Nijmegen. Dr. J.A.J.M. Taminiau, kinderarts-gastro-enteroloog, Emma Kinderziekenhuis/amc, Amsterdam.
Correspondentieadres: Prof.dr. H.A. Heij, afdeling Kinderchirurgie, ekz/amc g8-238, Meibergdreef 9, 1105 AZ Amsterdam
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Heij, H.A., Severijnen, R.S.V.M. & Taminiau, J.A.J.M. Chirurgische interventies ter verbetering van de darmfunctie bij het kortedarmsyndroom. KIND 74, 183–187 (2006). https://doi.org/10.1007/BF03061628
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DOI: https://doi.org/10.1007/BF03061628