Skip to main content
Log in

Short Bowel Syndrome: A Practical Pathway Leading to Successful Enteral Autonomy

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Short bowel syndrome is a multisystemic disorder that results from the loss of a significant amount of small bowel. The goal of treatment in these patients is to achieve complete enteral autonomy while minimizing complications. Our unit has 30 years of experience in the management of short gut patients. During the past decade, our results have improved significantly, especially in children with severe short bowel syndrome. This brief communication looks at the algorithm presently used in our unit.

Methods

In this communication, the principles in management of short bowel syndrome in our unit are discussed. In addition, our algorithm is published for the first time. A brief summary of our results is provided.

Results

Twenty-seven children were enrolled from 2000 to 2009. In this cohort, two patients died because of significant liver disease: one after having two liver and bowel transplants. Overall, survival stands at 92%. All had autologous gastrointestinal reconstruction, and 19 patients underwent bowel lengthening (longitudinal intestinal lengthening and tailoring). The median residual length of bowel of this subgroup at first operation was 25 cm in those who had their gut measured. Two patients were lost to follow-up. Two patients remain on supplemental total parenteral nutrition (TPN), with an overall 91% of surviving patients off TPN at a median of 6 months after reconstruction.

Conclusions

We believe this improvement is related to the development—over many years—of a structured pathway for managing these patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

References

  1. Bianchi A (1999) Experience with longitudinal intestinal lengthening and tailoring. Eur J Pediatr Surg 9(4):256–259

    Article  PubMed  CAS  Google Scholar 

  2. Khalil BA, Gillham JC, Foresythe L et al (2010) Successful management of short gut due to vanishing gastroschisis: case report and review of the literature. Ann R Coll Surg Engl 92(5):W10–W13

    Article  PubMed  CAS  Google Scholar 

  3. Murphy F, Khalil BA, Gozzini S et al (2011) Controlled tissue expansion in the initial management of the short bowel state. World J Surg 35(5):1142–1145

    Article  PubMed  CAS  Google Scholar 

  4. Bianchi A (2006) From the cradle to enteral autonomy: the role of autologous gastrointestinal reconstruction. Gastroenterology 130(2 Suppl 1):S138–S146

    Article  PubMed  Google Scholar 

  5. Kim HB, Fauza D, Garza J et al (2003) Serial transverse enteroplasty (STEP): a novel bowel lengthening procedure. J Pediatr Surg 38:425–429

    Article  PubMed  Google Scholar 

  6. Kimura K, Soper RT (1993) A new bowel elongation technique for the short bowel syndrome using the isolated bowel segment IOWA models. J Pediatr Surg 28(6):792–794

    Article  PubMed  CAS  Google Scholar 

  7. Devesa JM, Botella-Carretero JI, Lopez Hervas P et al (2008) Ultrashort bowel syndrome: survival management and long term results of an exceptional case. J Pediatr Surg 43(3):E5–E9

    Article  PubMed  Google Scholar 

  8. Khalil BA, Ba’ath ME, Aziz A et al (2011) Intestinal rehabilitation and bowel reconstructive surgery: improved outcomes in children with short bowel syndrome. J Pediatr Gastroenterol Nutr [Epub ahead of print]

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. Morabito.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ba’ath, M.E., Almond, S., King, B. et al. Short Bowel Syndrome: A Practical Pathway Leading to Successful Enteral Autonomy. World J Surg 36, 1044–1048 (2012). https://doi.org/10.1007/s00268-012-1512-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-012-1512-5

Keywords

Navigation