Surgical approach to short-bowel syndrome

Experience in a population of 160 patients

Jon S Thompson, Alan Norman Langnas, L. W. Pinch, S. Kaufman, E. M M Quigley, J. A. Vanderhoof, J. E. Fischer, B. M. Jaffe, R. R. Bollinger

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Abstract

Objective: The authors reviewed their experience with short bowel syndrome to define the surgical approach to this problem in 160 patients. Methods: Forty-eight adults and 112 children were evaluated over a 15-year period. Results: Seventy-one patients (44%) adapted to resection and took enteral nutrition alone. Forty four patients (28%) were supported by parenteral nutrition (PN). Forty-five patients (28%) have had 49 surgical procedures. Fifteen patients with adequate intestinal length (> 120 cm in adults) but dilated dysfunctional bowel underwent stricturoplasty (n = 4) or tapering (n = 11). Thirteen patients (87%) demonstrated clinical improvement. Fourteen patients with shorter remnants (90120 cm) and rapid transit time received an artificial valve (n = 2) or a reversed segment (n = 1). All patients' conditions improved initially, but the reversed segment was revised or taken down. Fourteen patients with short remnants and dilated bowel underwent intestinal lengthening. Twelve patients' conditions improved (86%), one underwent transplantation, and one died. Sixteen patients with very short remnants (<60 cm) and complications of PN underwent solitary intestine (n = 4) or combined liver intestinal transplantation (n = 13). One-year graft survival was 65%. There have been five deaths. Conclusions: The surgical approach to short bowel syndrome depends on the patient's age, remnant length and caliber, intestinal function, and PN-related complications. Nontransplant procedures have a role in the treatment of selected patients. Intestinal transplantation is emerging as a potential therapy for patients with significant PN related complications.

Original languageEnglish (US)
Pages (from-to)600-607
Number of pages8
JournalAnnals of surgery
Volume222
Issue number4
DOIs
StatePublished - Jan 1 1995

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Short Bowel Syndrome
Population
Parenteral Nutrition
Transplantation
Enteral Nutrition
Graft Survival
Liver Transplantation

ASJC Scopus subject areas

  • Surgery

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Surgical approach to short-bowel syndrome : Experience in a population of 160 patients. / Thompson, Jon S; Langnas, Alan Norman; Pinch, L. W.; Kaufman, S.; Quigley, E. M M; Vanderhoof, J. A.; Fischer, J. E.; Jaffe, B. M.; Bollinger, R. R.

In: Annals of surgery, Vol. 222, No. 4, 01.01.1995, p. 600-607.

Research output: Contribution to journalArticle

Thompson, JS, Langnas, AN, Pinch, LW, Kaufman, S, Quigley, EMM, Vanderhoof, JA, Fischer, JE, Jaffe, BM & Bollinger, RR 1995, 'Surgical approach to short-bowel syndrome: Experience in a population of 160 patients', Annals of surgery, vol. 222, no. 4, pp. 600-607. https://doi.org/10.1097/00000658-199522240-00016
Thompson, Jon S ; Langnas, Alan Norman ; Pinch, L. W. ; Kaufman, S. ; Quigley, E. M M ; Vanderhoof, J. A. ; Fischer, J. E. ; Jaffe, B. M. ; Bollinger, R. R. / Surgical approach to short-bowel syndrome : Experience in a population of 160 patients. In: Annals of surgery. 1995 ; Vol. 222, No. 4. pp. 600-607.
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