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Long-term outcome in patients with short bowel syndrome after longitudinal intestinal lengthening and tailoring.
J Pediatr Gastroenterol Nutr. 2008 Nov; 47(5):573-8.JP

Abstract

OBJECTIVES

Longitudinal intestinal lengthening and tailoring (LILT) is a well-established surgical treatment for short bowel syndrome. It has been shown to enhance peristalsis, decrease bacterial overgrowth, and extend mucosal contact time for nutrients. We present the results of a long-term follow-up of patients who underwent LILT and define prognostic parameters for the survival of these patients.

PATIENTS AND METHODS

Between 1987 and 2006, 53 patients underwent LILT in our institution. The main diagnoses were gastroschisis, intestinal volvulus, intestinal atresias, and necrotizing enterocolitis. LILT was performed at a mean age of 24 months (range 4144 months). The follow-up time was 79.76 months (range 6234 months).

RESULTS

After LILT, 41 of 53 patients survived, and 36 of 41 surviving patients were successfully weaned from parenteral nutrition (PN). In long-term follow-up 79% stayed free of PN. The overall survival rate was 77.36%. Weight gain occurred in 58% of the patients after LILT. The quality of life after LILT is on a high level, with most patients having normal physical strength and participating in normal social life and education. Prognostic factors for survival after LILT in short bowel syndrome are length of small intestine (0.06582 + 0.0131 x bowel cm), length of large bowel (P = 0.039), preoperative liver function, and successful weaning from PN within 18 months postoperatively (P = 0.0032).

CONCLUSIONS

Patients undergoing LILT in short bowel syndrome have a high survival rate, weight gain, and a high quality of life. Autologous gastrointestinal reconstruction remains therefore the first choice in the treatment of patients with short bowel syndrome.

Authors+Show Affiliations

Department of Pediatric Surgery, Klinikum Mannheim gGmbH, Mannheim, Germany. Konrad.Reinshagen@kch.ma.uni-heidelberg.deNo affiliation info availableNo affiliation info availableNo 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

18979580

Citation

Reinshagen, K, et al. "Long-term Outcome in Patients With Short Bowel Syndrome After Longitudinal Intestinal Lengthening and Tailoring." Journal of Pediatric Gastroenterology and Nutrition, vol. 47, no. 5, 2008, pp. 573-8.
Reinshagen K, Kabs C, Wirth H, et al. Long-term outcome in patients with short bowel syndrome after longitudinal intestinal lengthening and tailoring. J Pediatr Gastroenterol Nutr. 2008;47(5):573-8.
Reinshagen, K., Kabs, C., Wirth, H., Hable, N., Brade, J., Zahn, K., Hagl, C., Jester, I., & Waag, K. L. (2008). Long-term outcome in patients with short bowel syndrome after longitudinal intestinal lengthening and tailoring. Journal of Pediatric Gastroenterology and Nutrition, 47(5), 573-8.
Reinshagen K, et al. Long-term Outcome in Patients With Short Bowel Syndrome After Longitudinal Intestinal Lengthening and Tailoring. J Pediatr Gastroenterol Nutr. 2008;47(5):573-8. PubMed PMID: 18979580.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term outcome in patients with short bowel syndrome after longitudinal intestinal lengthening and tailoring. AU - Reinshagen,K, AU - Kabs,C, AU - Wirth,H, AU - Hable,N, AU - Brade,J, AU - Zahn,K, AU - Hagl,C, AU - Jester,I, AU - Waag,K L, PY - 2008/11/4/pubmed PY - 2009/2/14/medline PY - 2008/11/4/entrez SP - 573 EP - 8 JF - Journal of pediatric gastroenterology and nutrition JO - J Pediatr Gastroenterol Nutr VL - 47 IS - 5 N2 - OBJECTIVES: Longitudinal intestinal lengthening and tailoring (LILT) is a well-established surgical treatment for short bowel syndrome. It has been shown to enhance peristalsis, decrease bacterial overgrowth, and extend mucosal contact time for nutrients. We present the results of a long-term follow-up of patients who underwent LILT and define prognostic parameters for the survival of these patients. PATIENTS AND METHODS: Between 1987 and 2006, 53 patients underwent LILT in our institution. The main diagnoses were gastroschisis, intestinal volvulus, intestinal atresias, and necrotizing enterocolitis. LILT was performed at a mean age of 24 months (range 4144 months). The follow-up time was 79.76 months (range 6234 months). RESULTS: After LILT, 41 of 53 patients survived, and 36 of 41 surviving patients were successfully weaned from parenteral nutrition (PN). In long-term follow-up 79% stayed free of PN. The overall survival rate was 77.36%. Weight gain occurred in 58% of the patients after LILT. The quality of life after LILT is on a high level, with most patients having normal physical strength and participating in normal social life and education. Prognostic factors for survival after LILT in short bowel syndrome are length of small intestine (0.06582 + 0.0131 x bowel cm), length of large bowel (P = 0.039), preoperative liver function, and successful weaning from PN within 18 months postoperatively (P = 0.0032). CONCLUSIONS: Patients undergoing LILT in short bowel syndrome have a high survival rate, weight gain, and a high quality of life. Autologous gastrointestinal reconstruction remains therefore the first choice in the treatment of patients with short bowel syndrome. SN - 1536-4801 UR - https://www.unboundmedicine.com/medline/citation/18979580/Long_term_outcome_in_patients_with_short_bowel_syndrome_after_longitudinal_intestinal_lengthening_and_tailoring_ L2 - https://doi.org/10.1097/mpg.0b013e31816232e3 DB - PRIME DP - Unbound Medicine ER -