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The use of multiple serial transverse enteroplasty (STEP) procedures for the management of intestinal atresia and short bowel syndrome.
Am Surg. 2013 Aug; 79(8):826-8.AS

Abstract

The serial transverse enteroplasty procedure (STEP) was introduced as a bowel-lengthening procedure to reduce complications related to short bowel syndrome (SBS). Although some have described it as a useful adjunct to the Bianci procedure, others have acknowledged it as a primary procedure. We present a case of jejunal atresia in which two STEP procedures were performed 7 months apart to increase small bowel length. A 1-day-old, term girl presented with a known bowel obstruction diagnosed in utero. A laparotomy revealed a Type IIIb jejunal atresia with no remaining small bowel or cecum. A STEP procedure with an end jejunostomy and ascending colon mucous fistula lengthened the small bowel from 35 to 50 cm. A repeat procedure 7 months later lengthened it to 89 cm. The STEP procedure results in slower intestinal transit time and increases enterocytes contact with oral intake. We performed it during our initial exploration to increase small bowel size by 30 per cent. A repeat procedure 7 months later increased length to 89 cm. The use of multiple, staged STEP procedures avoided the need for bowel transplantation and long-term total parenteral nutrition dependence, demonstrating its effectiveness as a primary procedure for the surgical management of SBS.

Authors+Show Affiliations

Department of General Surgery, Georgia Regents University, Augusta, Georgia 30912, USA. vbhalla@gru.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

23896253

Citation

Bhalla, Varun K., et al. "The Use of Multiple Serial Transverse Enteroplasty (STEP) Procedures for the Management of Intestinal Atresia and Short Bowel Syndrome." The American Surgeon, vol. 79, no. 8, 2013, pp. 826-8.
Bhalla VK, Pipkin WL, Hatley RM, et al. The use of multiple serial transverse enteroplasty (STEP) procedures for the management of intestinal atresia and short bowel syndrome. Am Surg. 2013;79(8):826-8.
Bhalla, V. K., Pipkin, W. L., Hatley, R. M., & Howell, C. G. (2013). The use of multiple serial transverse enteroplasty (STEP) procedures for the management of intestinal atresia and short bowel syndrome. The American Surgeon, 79(8), 826-8.
Bhalla VK, et al. The Use of Multiple Serial Transverse Enteroplasty (STEP) Procedures for the Management of Intestinal Atresia and Short Bowel Syndrome. Am Surg. 2013;79(8):826-8. PubMed PMID: 23896253.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The use of multiple serial transverse enteroplasty (STEP) procedures for the management of intestinal atresia and short bowel syndrome. AU - Bhalla,Varun K, AU - Pipkin,Walter L, AU - Hatley,Robyn M, AU - Howell,Charles G, PY - 2013/7/31/entrez PY - 2013/7/31/pubmed PY - 2013/10/1/medline SP - 826 EP - 8 JF - The American surgeon JO - Am Surg VL - 79 IS - 8 N2 - The serial transverse enteroplasty procedure (STEP) was introduced as a bowel-lengthening procedure to reduce complications related to short bowel syndrome (SBS). Although some have described it as a useful adjunct to the Bianci procedure, others have acknowledged it as a primary procedure. We present a case of jejunal atresia in which two STEP procedures were performed 7 months apart to increase small bowel length. A 1-day-old, term girl presented with a known bowel obstruction diagnosed in utero. A laparotomy revealed a Type IIIb jejunal atresia with no remaining small bowel or cecum. A STEP procedure with an end jejunostomy and ascending colon mucous fistula lengthened the small bowel from 35 to 50 cm. A repeat procedure 7 months later lengthened it to 89 cm. The STEP procedure results in slower intestinal transit time and increases enterocytes contact with oral intake. We performed it during our initial exploration to increase small bowel size by 30 per cent. A repeat procedure 7 months later increased length to 89 cm. The use of multiple, staged STEP procedures avoided the need for bowel transplantation and long-term total parenteral nutrition dependence, demonstrating its effectiveness as a primary procedure for the surgical management of SBS. SN - 1555-9823 UR - https://www.unboundmedicine.com/medline/citation/23896253/The_use_of_multiple_serial_transverse_enteroplasty__STEP__procedures_for_the_management_of_intestinal_atresia_and_short_bowel_syndrome_ L2 - http://www.diseaseinfosearch.org/result/6576 DB - PRIME DP - Unbound Medicine ER -