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Risk factors for short bowel syndrome in patients with Crohn’s disease

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Abstract

Purpose

Patients with Crohn’s disease (CD) often need home parenteral nutrition for short bowel syndrome (SBS), as a result of frequent surgery and extended bowel resections. We conducted this study to evaluate the influence of the patient’s condition on the occurrence of SBS in CD.

Methods

The subjects of this study were 721 patients, who underwent bowel resections for CD at Hyogo College of Medicine between September 1974 and September 2010. The collective total of bowel resection operations was 1286. The possible risk factors for SBS were analyzed by univariate and multivariate logistic regression analyses to determine their predictive significance.

Results

SBS was diagnosed in 24 patients. A stepwise logistic regression model revealed that penetrating type (odds ratio 14.9, p = 0.02), remaining small intestine <200 cm (odds ratio 141.4, p < 0.01), ostomy creation (odds ratio 7.5, p = 0.03), and post-total colectomy (odds ratio 17.6, p < 0.01) were independent risk factors for SBS.

Conclusion

These results indicate that the length of remaining small bowel is closely related to SBS in patients who have undergone surgery for CD. At least 200 cm of small bowel should be preserved to prevent SBS when total colectomy and ostomy creation are performed for CD.

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References

  1. Richards DM, Deeks JJ, Sheldon TA, Shaffer JL. Home parenteral nutrition: a systematic review. Health Technol Assess. 1997;1:i–iii, 1–59.

    Google Scholar 

  2. Buchman AL, Scolapio J, Fryer J. AGA technical review on short bowel syndrome and intestinal transplantation. Gastroenterology. 2003;124:1111–34.

    Article  PubMed  Google Scholar 

  3. Messing B, Crenn P, Beau P, Boutron-Ruault MC, Rambaud JC, Matuchansky C. Long-term survival and parenteral nutrition dependence in adult patients with short bowel syndrome. Gastroenterology. 1999;117:1043–50.

    Article  PubMed  CAS  Google Scholar 

  4. Nightingale JM, Lennard-Jones JE, Gertner DJ, Wood SR, Bartram CI. Colonic preservation reduces need for parenteral therapy, increases incidence of renal stones, but does not change high prevalence of gallstones in patients with a short bowel. Gut. 1992;33:1493–7.

    Article  PubMed  CAS  Google Scholar 

  5. Nightingale JM, Lennard-Jones JE, Walker ER, Farthing MJ. Jejunal efflux in short bowel syndrome. Lancet. 1990;336:765–8.

    Article  PubMed  CAS  Google Scholar 

  6. Nightingale JMD, Lennard-Jones JE. Adult patient with a short bowel due to Crohn’s disease often start with a short normal bowel. Eur J Gastroenterol Hepatol. 1995;7:989–91.

    Article  PubMed  CAS  Google Scholar 

  7. Galandiuk S, O’Neill M, McDonald P, Fazio VW, Steiger E. A century of HPN for Crohn’s disease. Am J Surg. 1990;159:540–5.

    Article  PubMed  CAS  Google Scholar 

  8. Nightingale JMD, Lennard-Jones JE. The short bowel syndrome: what’s new and old? Dig Dis. 1993;11:12–31.

    Article  PubMed  CAS  Google Scholar 

  9. Krukchubasche AG, Rowe MI, Smith SD. Adaptation in short-bowel syndrome: reassessing old limits. J Pediatr Surg. 1993;28:1069–71.

    Article  Google Scholar 

  10. Goday PS. Short bowel syndrome: how short is too short? Clin Perinatol. 2009;36:101–10.

    Article  PubMed  Google Scholar 

  11. Agwunobi AO, Carlson GL, Anderson ID, Irving MH, Scott NA. Mechanisms of intestinal failure in Crohn’s disease. Dis Colon Rectum. 2001;44:1834–7.

    Article  PubMed  CAS  Google Scholar 

  12. Thompson JS, Iyer KR, DiBaise JK, Young RL, Brown CR, Langnas AN. Short bowel syndrome and Crohn’s disease. J Gastrointest Surg. 2003;7:1069–72.

    Article  PubMed  Google Scholar 

  13. Glehen O, Lifante JC, Vignal J, Francois Y, Gilly FN, Flourié B, Descos L, Chung RJ, Mithieux F. Small bowel length in Crohn’s disease. Int J Colorectal Dis. 2003;18:423–7.

    Article  PubMed  CAS  Google Scholar 

  14. Uchino M, Ikeuchi H, Matsuoka H, Matsumoto T, Takesue Y, Tomita N. Long-term efficacy of strictureplasty for Crohn’s disease. Surg Today. 2010;40:949–53.

    Article  PubMed  Google Scholar 

  15. Pullan JM. Massive intestinal resection. Proc R Soc Med. 1959;52:31–7.

    PubMed  CAS  Google Scholar 

  16. Winawer SJ, Zamcheck N. Pathophysiology of small intestinal resection in man. Progress in Gastroenterology, vol. 1. In: Glass GBJ, editor. New York: Grune & Strutton; 1968. p. 339–56.

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Conflict of interest

Motoi Uchino and his co-authors have no conflict of interest.

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Authors and Affiliations

  1. Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan

    Motoi Uchino, Hiroki Ikeuchi, Toshihiro Bando, Hiroki Matsuoka & Naohiro Tomita

  2. Department of Infection Control and Prevention, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan

    Yoshiko Takahashi & Yoshio Takesue

  3. Division of Lower Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan

    Takayuki Matsumoto

Authors
  1. Motoi Uchino
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  2. Hiroki Ikeuchi
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  3. Toshihiro Bando
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  4. Hiroki Matsuoka
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  5. Yoshiko Takahashi
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  6. Yoshio Takesue
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  7. Takayuki Matsumoto
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  8. Naohiro Tomita
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Corresponding author

Correspondence to Motoi Uchino.

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Uchino, M., Ikeuchi, H., Bando, T. et al. Risk factors for short bowel syndrome in patients with Crohn’s disease. Surg Today 42, 447–452 (2012). https://doi.org/10.1007/s00595-011-0098-0

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  • DOI: https://doi.org/10.1007/s00595-011-0098-0

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