Advertisement

Controlled Tissue Expansion

  • Riccardo Coletta
  • Antonino MorabitoEmail author
Chapter

Abstract

In patients suffering from short bowel syndrome, bowel dilatation can occur either spontaneously during the intestinal adaptation phase or can be triggered by formation of tube stomas. Controlled tissue expansion (CTE) is a surgical approach aiming to dilate remaining bowel in patient suffering from short bowel syndrome. CTE consists in clamping the proximal tube stoma and recycling the effluent in the distal bowel. The goal is to increase the length and circumferential diameter of the bowel during a period of 20–24 weeks. This creates a new and greater surface area for absorption and more tissue for lengthening and tailoring. CTE should be considered part of the armamentarium within an intestinal rehabilitation programme.

Keywords

Short Bowel Syndrome Bacterial Overgrowth Intestinal Adaptation Bowel Dilatation Distal Bowel 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

CTE

Controlled tissue expansion

NG

Nasogastric tube

References

  1. 1.
    Georgeson K, Halpin D, Figueroa R, Vincente Y, Hardin Jr W. Sequential intestinal lengthening procedures for refractory short bowel syndrome. J Pediatr Surg. 1994;29(2):316–20; discussion 20–1.CrossRefPubMedGoogle Scholar
  2. 2.
    Collins 3rd J, Vicente Y, Georgeson K, Kelly D. Partial intestinal obstruction induces substantial mucosal proliferation in the pig. J Pediatr Surg. 1996;31(3):415–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Bianchi A. From the cradle to enteral autonomy: the role of autologous gastrointestinal reconstruction. Gastroenterology. 2006;130(2 Suppl 1):S138–46.CrossRefPubMedGoogle Scholar
  4. 4.
    Khalil BA, Ba’ath ME, Aziz A, Forsythe L, Gozzini S, Murphy F, et al. Intestinal rehabilitation and bowel reconstructive surgery: improved outcomes in children with short bowel syndrome. J Pediatr Gastroenterol Nutr. 2012;54(4):505–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Coletta R, Khalil BA, Morabito A. Short bowel syndrome in children: surgical and medical perspectives. Semin Pediatr Surg. 2014;23(5):291–7.CrossRefPubMedGoogle Scholar
  6. 6.
    Marnerides A, Ghazi S, Sundberg A, Papadogiannakis N. Development of fetal intestinal length during 2nd-trimester in normal and pathologic pregnancies. Pediatr Dev Pathol. 2012;15(1):24–9.CrossRefPubMedGoogle Scholar
  7. 7.
    Murphy F, Khalil BA, Gozzini S, King B, Bianchi A, Morabito A. Controlled tissue expansion in the initial management of the short bowel state. World J Surg. 2011;35(5):1142–5.CrossRefPubMedGoogle Scholar
  8. 8.
    Pataki I, Szabo J, Varga P, Berkes A, Nagy A, Murphy F, et al. Recycling of bowel content: the importance of the right timing. J Pediatr Surg. 2013;48(3):579–84.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Paediatric Autologous Bowel Reconstruction and Rehabilitation UnitRoyal Manchester Children’s HospitalManchesterUK
  2. 2.Institute of Human Development, Faculty of Medical and Human SciencesUniversity of ManchesterManchesterUK
  3. 3.School of Environment and Life Sciences - University of SalfordManchesterUK
  4. 4.University of Manchester and Royal Manchester Children’s HospitalManchesterUK

Personalised recommendations