Surgical therapy for the short bowel syndrome

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

The introduction of total parenteral nutrition has resulted in more patients surviving massive intestinal resection. Long-term parenteral nutrition is expensive, has potential complications, and causes inconvenience for the patient. Therefore, interest persists in surgical therapy for the short bowel syndrome. The goals of surgical therapy in the short bowel syndrome are to slow intestinal transit, increase the area of absorption, and reduce gastric hyperacidity. Patients with sufficient absorptive area, but rapid intestinal transit, benefit from antiperistaltic segments or colon interposition. Intestinal valves yield inconsistent results. Recirculating loops are associated with prohibitive morbidity and mortality. Experience with intestinal pacing is limited. Patients with dilated bowel segments may benefit from intestinal tapering or lengthening. Growing neomucosa holds promise but has not been evaluated clinically. Recent improvement in the results of intestinal transplantation in animals may warrant clinical trials. The efficacy of H2 receptor antagonists makes procedures for reducing gastric hyperacidity less necessary. None of the operations to treat the short bowel syndrome are sufficiently safe and effective to recommend their routine use. Operations should be performed only on selected patients to achieve specific goals. Although investigation continues, our emphasis should continue to be conservation of as much of the intestine as possible when massive resection is necessary.

Original languageEnglish (US)
Pages (from-to)81-91
Number of pages11
JournalJournal of Surgical Research
Volume39
Issue number1
DOIs
StatePublished - Jul 1985

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Short Bowel Syndrome
Antidiarrheals
Therapeutics
Histamine H2 Receptors
Total Parenteral Nutrition
Parenteral Nutrition
Intestines
Stomach
Colon
Transplantation
Clinical Trials
Morbidity
Mortality

ASJC Scopus subject areas

  • Surgery

Cite this

Surgical therapy for the short bowel syndrome. / Thompson, Jon S.

In: Journal of Surgical Research, Vol. 39, No. 1, 07.1985, p. 81-91.

Research output: Contribution to journalArticle

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