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Evaluation of intestinal absorption after longitudinal intestinal lengthening for short bowel syndrome.
J Pediatr Surg. 2005 Oct; 40(10):1587-91.JP

Abstract

PURPOSE

The aim of this study was to answer if the longitudinal intestinal lengthening and tailoring (LILT) by Bianchi, modified by Aigrain, can allow the child to be weaned from parenteral nutrition (PN) and if the length of the bowel after the procedure can influence the results of the absorption test such as Schilling or D-xylose test.

PATIENTS AND METHODS

We reviewed the files of 7 children who have had LILT from 1980 to 2003. We performed to explore 2 intestinal function tests: the D-xylose and the Schilling tests. Both were performed early (during the first year after the procedure) and late (during the second year) after the LILT. We used the chi2 and Bartlett's correlation tests for statistical analysis.

RESULTS

There were 6 boys and 1 girl. The surgical indication was short bowel syndrome with parenteral nutrition owing to multiple intestinal atresia (2 cases), severe necrotizing enterocolitis with volvulus (1 case), necrotizing enterocolitis (1 case), intestinal atresia with gastroschisis (2 cases), and volvulus owing to malrotation (1 case). The length of the bowel was significantly different before and after LILT (P < .0001). After LILT, the length of the bowel was significantly correlated with the percentage of PN on energy at 6 months (P = .02) and at 12 months (P = .001). Moreover, the length of the bowel after the procedure was significantly correlated with the results of the D-xylose test during the first year (P = .002) but not with the results after the second year. The length after lengthening influenced neither the results of the Schilling test during the first nor those of the second year after. Four patients were weaned from the PN 21 months in average after the LILT (57%); 1 was not because we had only a 2-month follow-up. The average follow-up was 111 (5 months; range, 4-206).

CONCLUSION

Longitudinal intestinal lengthening and tailoring for short bowel syndrome is a good option to allow children to be weaned from the PN. The length of the bowel after the procedure can influence the absorption test such as D-xylose during the first postoperative year but not during the second and does not influence the Schilling test. We think it is not necessary to perform these tests during the follow-up of these patients.

Authors+Show Affiliations

Department of Pediatric Surgery, Hôpital Robert Debré, AP-HP, 75019 Paris, France. arnaud.bonnard@trs.ap-hop-paris.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16226989

Citation

Bonnard, Arnaud, et al. "Evaluation of Intestinal Absorption After Longitudinal Intestinal Lengthening for Short Bowel Syndrome." Journal of Pediatric Surgery, vol. 40, no. 10, 2005, pp. 1587-91.
Bonnard A, Staub G, Segura JF, et al. Evaluation of intestinal absorption after longitudinal intestinal lengthening for short bowel syndrome. J Pediatr Surg. 2005;40(10):1587-91.
Bonnard, A., Staub, G., Segura, J. F., Malbezin, S., Dorgeret, S., Aigrain, Y., & de Lagausie, P. (2005). Evaluation of intestinal absorption after longitudinal intestinal lengthening for short bowel syndrome. Journal of Pediatric Surgery, 40(10), 1587-91.
Bonnard A, et al. Evaluation of Intestinal Absorption After Longitudinal Intestinal Lengthening for Short Bowel Syndrome. J Pediatr Surg. 2005;40(10):1587-91. PubMed PMID: 16226989.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of intestinal absorption after longitudinal intestinal lengthening for short bowel syndrome. AU - Bonnard,Arnaud, AU - Staub,Guillaume, AU - Segura,Jean-François, AU - Malbezin,Serge, AU - Dorgeret,Sophie, AU - Aigrain,Yves, AU - de Lagausie,Pascal, PY - 2005/10/18/pubmed PY - 2006/4/1/medline PY - 2005/10/18/entrez SP - 1587 EP - 91 JF - Journal of pediatric surgery JO - J Pediatr Surg VL - 40 IS - 10 N2 - PURPOSE: The aim of this study was to answer if the longitudinal intestinal lengthening and tailoring (LILT) by Bianchi, modified by Aigrain, can allow the child to be weaned from parenteral nutrition (PN) and if the length of the bowel after the procedure can influence the results of the absorption test such as Schilling or D-xylose test. PATIENTS AND METHODS: We reviewed the files of 7 children who have had LILT from 1980 to 2003. We performed to explore 2 intestinal function tests: the D-xylose and the Schilling tests. Both were performed early (during the first year after the procedure) and late (during the second year) after the LILT. We used the chi2 and Bartlett's correlation tests for statistical analysis. RESULTS: There were 6 boys and 1 girl. The surgical indication was short bowel syndrome with parenteral nutrition owing to multiple intestinal atresia (2 cases), severe necrotizing enterocolitis with volvulus (1 case), necrotizing enterocolitis (1 case), intestinal atresia with gastroschisis (2 cases), and volvulus owing to malrotation (1 case). The length of the bowel was significantly different before and after LILT (P < .0001). After LILT, the length of the bowel was significantly correlated with the percentage of PN on energy at 6 months (P = .02) and at 12 months (P = .001). Moreover, the length of the bowel after the procedure was significantly correlated with the results of the D-xylose test during the first year (P = .002) but not with the results after the second year. The length after lengthening influenced neither the results of the Schilling test during the first nor those of the second year after. Four patients were weaned from the PN 21 months in average after the LILT (57%); 1 was not because we had only a 2-month follow-up. The average follow-up was 111 (5 months; range, 4-206). CONCLUSION: Longitudinal intestinal lengthening and tailoring for short bowel syndrome is a good option to allow children to be weaned from the PN. The length of the bowel after the procedure can influence the absorption test such as D-xylose during the first postoperative year but not during the second and does not influence the Schilling test. We think it is not necessary to perform these tests during the follow-up of these patients. SN - 1531-5037 UR - https://www.unboundmedicine.com/medline/citation/16226989/Evaluation_of_intestinal_absorption_after_longitudinal_intestinal_lengthening_for_short_bowel_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3468(05)00478-1 DB - PRIME DP - Unbound Medicine ER -