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The First Clinical Application of the Spiral Intestinal Lengthening and Tailoring (Silt) in Extreme Short Bowel Syndrome

  • Case Report
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Aim

Spiral Intestinal Lengthening and Tailoring (SILT) invented by our team is a new technique that offers minimal mesenteric handling and a more physiological result compared to the STEP procedure. Its feasibility has been tested in animal models and now we report the first successful human application in extreme short bowel syndrome.

Materials and Methods

A 3-year-old girl suffered subtotal loss of her small bowel and ileocaecal junction as a result of midgut volvulus. Only 15 cm of jejunum remained intact. Parenteral nutrition (PN), gastrostomy feeding, controlled bowel expansion and SILT procedure were applied.

Results

The length of the jejunum increased from the initial 15 to 22 cm during 12 months of PN and bowel expansion. Eleven centimeter of distended bowel was further lengthened up to 20 cm by SILT giving a total small bowel length of 31 cm. Oral and gastrostomy feedings were commenced 5 days postoperatively. There were no surgical complications 6 months after the procedure. The patient’s liver function was preserved, she was weaned off PN, discharged from hospital, but remained on gastrostomy top up feeding. The net weight gain of the patient was 1,800 g 6 months after the procedure.

Conclusion

SILT procedure is a safe and feasible technique for human intestinal lengthening and tailoring.

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Author information

Authors and Affiliations

  1. Department of Pediatrics, Josa Andras Hospital Nyíregyháza, Teaching Hospital of Medical Health Science Centre University of Debrecen, Debrecen, Hungary

    T. Cserni, B. Biszku, I. Guthy, F. Dicso & L. Szaloki

  2. Department of Pediatric Surgery, Royal Manchester Children’s University Hospital, Royal Manchester, UK

    T. Cserni, S. Folaranmi, F. Murphy, G. Rakoczy, A. Bianchi & A. Morabito

Authors
  1. T. Cserni
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  2. B. Biszku
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  3. I. Guthy
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  4. F. Dicso
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  5. L. Szaloki
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  6. S. Folaranmi
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  7. F. Murphy
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  8. G. Rakoczy
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  9. A. Bianchi
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  10. A. Morabito
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Corresponding author

Correspondence to T. Cserni.

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Cserni, T., Biszku, B., Guthy, I. et al. The First Clinical Application of the Spiral Intestinal Lengthening and Tailoring (Silt) in Extreme Short Bowel Syndrome. J Gastrointest Surg 18, 1852–1857 (2014). https://doi.org/10.1007/s11605-014-2577-2

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  • DOI: https://doi.org/10.1007/s11605-014-2577-2

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