Comparison of LILT and STEP procedures in children with short bowel syndrome — A systematic review of the literature

Frongia, Giovanni; Keßler, M.; Weih, Sandra; Nickkholgh, Arash; Mehrabi, Arianeb; Holland‐Cunz, Stefan

doi:10.1016/j.jpedsurg.2013.05.018

Cited by 91 publications

(78 citation statements)

References 67 publications

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“…A recent review by Frongia et al 35 extracted data from 39 retrospective case series on 363 and 109 patients undergoing LILT and STEP procedures, respectively. They found the procedures to have similar historical impact on improvement of enteral nutrition and reversal of parenteral nutrition-related complications, but a slightly lower rate of mortality and progression to transplantation for the STEP procedure.…”

Section: Resultsmentioning

confidence: 99%

Surgical options to enhance intestinal function in patients with short bowel syndrome

Sommovilla

Warner

2014

Current Opinion in Pediatrics

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Purpose of review This review will provide the practitioner with an understanding of the spectrum of non-transplant surgical options for managing patients with short bowel syndrome. Recent findings Intestinal lengthening procedures are promising therapy to allow for autonomy from parenteral nutrition. The recently described serial transverse enteroplasty is an effective procedure that is easier to perform and has similar outcomes to the more standard longitudinal lengthening procedure described by Bianchi. Summary There are several surgical options for management of the short bowel syndrome and include construction of intestinal valves or reversed intestinal segments, interposition of segments of colon, or intestinal lengthening procedures. The choice of technique is dictated by the patients underlying pathophysiology and includes such factors as intestinal transit time, length of remnant bowel, presence of intact colon, and degree of small bowel dilation. Non-transplant surgical interventions are important adjuncts to the elimination of parenteral nutrition dependence and need for intestinal transplantation.

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Section: Resultsmentioning

confidence: 99%

Surgical options to enhance intestinal function in patients with short bowel syndrome

Sommovilla

Warner

2014

Current Opinion in Pediatrics

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“…Güncel bir karşılaştırmanın sonucunda (80) (77) . Bu çalışmada da, 97 hastada 2,4-37,8 ay takipleri sonucunda %11 mortalite belirtilmiştir.…”

Section: Lilt-step Karşılaştırmasıunclassified

Intestinal Failure/Nontransplant surgical interventions for short bowel syndrome

Çelik¹

2017

tcdd

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Öz GirişBağırsak sisteminin bireyin besin alımı ve sıvı dengesini sağlamada yetersiz kaldığı durumlara bağırsak yetmezliği adı verilmektedir. Bağırsak uzunluğunun azaldığı, ileoçekal valvin olmadığı, kolonun kaybedildiği gibi uzunluk kayıpları veya mukozal yetmezlik, dismotilite veya aktif enterit gibi besin emiliminin mümkün olmadığı durumlarda birey kalıcı veya uzun süreli total parenteral beslenmeye mecbur kalabilmektedir (1) . "Büyüme için gerekli sıvı ve besinlerin sindirimi ve emilimi için yeterli miktarda fonksiyonel bağırsak kalmaması" pediatrik bağırsak yetmezliğinin modern tanımlamasıdır. Bir başka tanımda ise, büyüme, hidrasyon ve elektrolit homeostazının bozulmasına neden olan bağırsak hastalığı olarak genellenebilmektedir.

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“…Reversed segment lengths of 10-15 cm for adults and around 3 cm for children have been suggested to provide maximum benefits, but establishing the ideal length and location of the reversed bowel segment remains uncertain and produces variable results when clinically applied; e.g., this technique cannot be used when the remnant bowel is <25 cm [49]. For patients with rapid intestinal transit and who do not present bowel dilation, small bowel segmental reversal may cut PN requirements [49][50][51][52].…”

Section: Surgical Treatmentmentioning

confidence: 99%

“…Both procedures offer a similar extent of intestinal lengthening (approximately 70%) and results in improved enteral nutrition and the reversal of PN complications. For carefully selected patients with rapid intestinal transit and a dilated bowel, LILT and STEP procedures may prove beneficial [49,52]. Outcomes following STEP and LILT are generally similar, and the choice between these procedures may depend on the surgeon´s preference.…”

Section: Surgical Treatmentmentioning

confidence: 99%

Surgical Options in Short Bowel Syndrome

Rodríguez-Montes¹

2016

J.Paedi.Care.Inol

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Short bowel syndrome is characterized by a significant reduction in the effective intestinal surface by an anatomical or functional loss of the small intestine. It mainly occurs after extensive bowel resection, intestinal intrinsic disease or surgical bypass. The main complications are mal-digestion, malnutrition, dehydration and, potentially, lethal lesions. The management, based on appropriate and individualized nutritional support, is complexand requires a multidisciplinary approach including dietary, fluid and pharmacological management, co-morbid disease management and, sometimes, surgery. Numerous surgical procedures to relieve the consequences of massive intestinal resection have been devised, but many have not been employed in human clinics and have remained in the experimental surgery field. The choice of technique is dictated by the patient´s underlying pathophysiology and includes such factors as age, intestinal transit time, length of remnant bowel, presence of intact colon, degree of small bowel dilation, and others. Autologous intestinal reconstruction includes various techniques which manipulate the bowel surgically to facilitate the bowel adaptation process and restoration of enteral nutrition. The most accepted techniques are those elongating the bowel that may be applied only on dilated bowel. However, the intestinal transplantation can be a curative alternative for patients in whom intestinal rehabilitation attempts have failed and who are at risk of life-threatening parenteral nutrition complications.

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Comparison of LILT and STEP procedures in children with short bowel syndrome — A systematic review of the literature

Cited by 91 publications

References 67 publications

Surgical options to enhance intestinal function in patients with short bowel syndrome

Surgical options to enhance intestinal function in patients with short bowel syndrome

Intestinal Failure/Nontransplant surgical interventions for short bowel syndrome

Surgical Options in Short Bowel Syndrome

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