Intestinal resection in adults: Causes and consequences

G. J. Blatchford, Jon S Thompson, L. F. Rikkers

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

We reviewed the records of 160 adult patients undergoing intestinal resection to determine the outcome of this surgical procedure. Twenty-three patients (14%) underwent massive (> 50%) resection and 18 developed the short bowel syndrome. Mesenteric vascular disease was the indication for resection in 16 (70%) of these patients. The most frequent indications for resection in the 137 patients (86%) undergoing less extensive resection were: obstruction (26%); tumor (23%); Crohn’s disease (22%), and trauma (10%). Previous resection had been performed in 22 of these patients and the short bowel syndrome resulted in 6 patients. The morbidity and mortality rates of massive intestinal resection were significantly greater than for lesser resection (87 vs. 42 and 43 vs. 12%, respectively, p < 0.05). Massive resection was also more frequently an emergency procedure (87 vs. 40%, p < 0.05) and more likely to necessitate ostomy formation (48 vs. 15%, p < 0.005). Seventeen of the 24 patients with the short bowel syndrome survived and 14 required total parenteral nutrition (TPN) at home. Eleven patients remain alive on TPN with follow-up of 13-64 months. Intestinal resection is associated with greater morbidity than generally appreciated. The short bowel syndrome occurred in 15% of patients and while it most often resulted from massive resection (75%), it also frequently followed sequential lesser resections (25%). Home TPN has made long-term survival possible for many patients (70%) with the short bowel syndrome.

Original languageEnglish (US)
Pages (from-to)57-61
Number of pages5
JournalDigestive Surgery
Volume6
Issue number2
DOIs
Publication statusPublished - Jan 1 1989

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Keywords

  • Intestinal resection
  • Short bowel syndrome

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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