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Adaptation in short-bowel syndrome: reassessing old limits.
J Pediatr Surg. 1993 Aug; 28(8):1069-71.JP

Abstract

The improving survival of patients with severe short-bowel syndrome along with the advent of successful intestinal transplantation have accentuated the need to answer two questions. (1) Is there an intestinal length below which adaptation to full enteral nutrition can not be expected to occur? (2) How much time is necessary to complete intestinal adaptation? We reviewed the outcome of 21 infants with less than 50 cm of small intestine to answer these questions. Patients were divided into three groups based on intestinal length, regardless of ileocecal valve status: group I, < 10 cm (n = 3); group II, 10 to 30 cm (n = 11); and group III, 30 to 50 cm (n = 7). Data were collected to assess survival, incidence of adaptation, time to adaptation, and causes of mortality. Infants in group I did not achieve intestinal adaptation to full enteral nutrition. One survived and 2 died, one from varicella pneumonia and the other after intestinal transplantation. Eight of the 11 (73%) patients in group II survived and 5 of 8 (63%) survivors achieved full intestinal adaptation after a mean interval of 320 days (range, 148 to 506 days) on parenteral nutrition. Six of the seven patients (86%) in group III survived and all survivors (100%) achieved complete enteral adaptation after an average of 376 days (range, 58 to 727 days). The overall survival was 71% (15/21), but survival in patients with > 10 cm was 78%.(

ABSTRACT

TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Department of Surgery, Children's Hospital of Pittsburgh, University of Pittsburgh, School of Medicine, PA 15213-2583.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8229598

Citation

Kurkchubasche, A G., et al. "Adaptation in Short-bowel Syndrome: Reassessing Old Limits." Journal of Pediatric Surgery, vol. 28, no. 8, 1993, pp. 1069-71.
Kurkchubasche AG, Rowe MI, Smith SD. Adaptation in short-bowel syndrome: reassessing old limits. J Pediatr Surg. 1993;28(8):1069-71.
Kurkchubasche, A. G., Rowe, M. I., & Smith, S. D. (1993). Adaptation in short-bowel syndrome: reassessing old limits. Journal of Pediatric Surgery, 28(8), 1069-71.
Kurkchubasche AG, Rowe MI, Smith SD. Adaptation in Short-bowel Syndrome: Reassessing Old Limits. J Pediatr Surg. 1993;28(8):1069-71. PubMed PMID: 8229598.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adaptation in short-bowel syndrome: reassessing old limits. AU - Kurkchubasche,A G, AU - Rowe,M I, AU - Smith,S D, PY - 1993/8/1/pubmed PY - 1993/8/1/medline PY - 1993/8/1/entrez SP - 1069 EP - 71 JF - Journal of pediatric surgery JO - J Pediatr Surg VL - 28 IS - 8 N2 - The improving survival of patients with severe short-bowel syndrome along with the advent of successful intestinal transplantation have accentuated the need to answer two questions. (1) Is there an intestinal length below which adaptation to full enteral nutrition can not be expected to occur? (2) How much time is necessary to complete intestinal adaptation? We reviewed the outcome of 21 infants with less than 50 cm of small intestine to answer these questions. Patients were divided into three groups based on intestinal length, regardless of ileocecal valve status: group I, < 10 cm (n = 3); group II, 10 to 30 cm (n = 11); and group III, 30 to 50 cm (n = 7). Data were collected to assess survival, incidence of adaptation, time to adaptation, and causes of mortality. Infants in group I did not achieve intestinal adaptation to full enteral nutrition. One survived and 2 died, one from varicella pneumonia and the other after intestinal transplantation. Eight of the 11 (73%) patients in group II survived and 5 of 8 (63%) survivors achieved full intestinal adaptation after a mean interval of 320 days (range, 148 to 506 days) on parenteral nutrition. Six of the seven patients (86%) in group III survived and all survivors (100%) achieved complete enteral adaptation after an average of 376 days (range, 58 to 727 days). The overall survival was 71% (15/21), but survival in patients with > 10 cm was 78%.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0022-3468 UR - https://www.unboundmedicine.com/medline/citation/8229598/Adaptation_in_short_bowel_syndrome:_reassessing_old_limits_ L2 - https://linkinghub.elsevier.com/retrieve/pii/0022-3468(93)90521-L DB - PRIME DP - Unbound Medicine ER -