Controlled Tissue Expansion in the Initial Management of the Short Bowel State

Murphy, Fiona; Khalil, Basem A.; Gozzini, Sara; King, B. A.; Bianchi, A.; Morabito, Antonino

doi:10.1007/s00268-011-0991-0

Cited by 37 publications

(28 citation statements)

References 7 publications

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“…Although the creation of neomucosa remains an elusive goal, use of sequential lengthening procedures and controlled tissue expansion (CTE) before bowel lengthening may have immediate, albeit limited, clinical application 35 , 36 . The theoretical basis for the strategy of CTE of nondilated bowel in preparation for definitive intestinal lengthening was laid out in experimental work on pigs by the demonstration of mucosal hypertrophy and gain in length and diameter of partially obstructed intestine 37 .…”

Section: Definitive Surgical Management Of Intestinal Failurementioning

confidence: 99%

Surgical Management of Short Bowel Syndrome

Iyer

2014

J Parenter Enteral Nutr

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For patients with short bowel syndrome (SBS), surgery can play an important role in preventing, mitigating, and, in some cases, reversing intestinal failure (IF). During intestinal resection, bowel length should be conserved to the fullest extent possible to avoid dependence on parenteral nutrition (PN). Bowel salvage may be improved by initially preserving tissue of questionable viability and later reevaluating during “second‐look” procedures. Once the patient is stabilized, ostomy reversal and recruitment of distal unused bowel should be prioritized whenever feasible. Following progression to IF, surgical management of SBS depends on the symptoms and anatomical characteristics of the individual patient. For carefully selected patients with rapid intestinal transit and dilated bowel, longitudinal intestinal lengthening and tailoring (LILT) and serial transverse enteroplasty (STEP) procedures may provide benefit. Outcomes following STEP and LILT are generally similar, and the choice between these procedures may rest on surgeon preference. For patients with rapid intestinal transit in the absence of bowel dilation, segmental reversal of the small bowel may reduce PN requirements. Intestinal transplantation is the standard of care for patients in whom intestinal rehabilitation attempts have failed and who are at risk of life‐threatening complications of PN. Because patients awaiting isolated intestine transplant show increased survival compared with patients awaiting combined intestine‐liver transplant, early referral of appropriate patients, before the development of advanced liver disease, is critical to enhancing patient outcomes.

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Section: Definitive Surgical Management Of Intestinal Failurementioning

confidence: 99%

Surgical Management of Short Bowel Syndrome

Iyer

2014

J Parenter Enteral Nutr

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“…They suggest the possibility of repeating the SILT in the event of further bowel dilatation. The management of children with short bowel should commence with 'controlled bowel expansion' for the residual autologous bowel to enhance natural adaptation and increase in length and to stimulate the development of additional 'new' tissue for reconstruction [4,8,9]. This sequence was fundamental to the management of our child with a length increase from 4 to 9 cm at 10 months.…”

Section: Discussionmentioning

confidence: 99%

“…The distal ileum was opened as a stoma. Controlled bowel expansion [4] was carried out by occlusion of the jejunostomy tube for increasing periods of time, but was eventually interrupted at 10 months of age because of significant leakage around the tube. A 3D-CT scan revealed the jejunum to have elongated from 4 to 9 cm with a diameter of \4 cm.…”

Section: Introductionmentioning

confidence: 99%

“Spiral intestinal lenghtening and tailoring (SILT)” for a child with severely short bowel

et al. 2014

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We report a child with post-surgical short bowel state who underwent bowel expansion followed by spiral intestinal lengthening and tailoring (SILT) at 10 months of age. Growth at 1-year follow-up is along the 15-25th centile on 82 % oral calories as normal diet and 18 % as parenteral nutrition, and he is passing 2-3 semisolid motions daily. SILT is a versatile technique for reconstructing dilated bowel towards improved propulsion and absorption, and has a role in the management of the short bowel state.

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“…Kontrollü doku ekspansiyonu-bağırsak germe (91) : Mukozal yüzeyi arttırmak amaçlı tanımlanmıştır. Cerrahi aşamalar olarak ilk laparotomide geniş çap-lı bir (12 fr Malecot katater) proksimal bağırsaktan geçirilip bir ileostomy/jejunostomi gibi batın duvarı-na tespit edilir, bir diğer ikinci tüp distal bağırsaktan ilerletilip aynı şekilde batın duvarından dışarıya tüp kolostomi gibi getirilir.…”

Section: Yazarunclassified

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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Controlled Tissue Expansion in the Initial Management of the Short Bowel State

Cited by 37 publications

References 7 publications

Surgical Management of Short Bowel Syndrome

Surgical Management of Short Bowel Syndrome

“Spiral intestinal lenghtening and tailoring (SILT)” for a child with severely short bowel

Intestinal Failure/Nontransplant surgical interventions for short bowel syndrome

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