Current practice and future perspectives in the treatment of short bowel syndrome in children—a systematic review

Abstract

The treatment of SBS patients remains very complex. It is eminent to find the best therapeutic option for each patient and to individualize and modify the different possible types of applied techniques frequently.

Short-Bowel Syndrome in Children — An Update in Management Strategies

“…These procedures pertain to autologous methods of intestinal reconstruction and could be categorized further into two subgroups: I) lengthening of the residual short bowel to provide satisfactory nutrient amount [48,49], and II) slowing of the intestinal transit [4]. Small bowel transplantation represents a separate option and has been proposed as an alternative for children with permanent intestinal failure and no longer tolerated parenteral nutrition (PN) [11,50].…”

“…This surgical technique has been used as an adjuvant method in cases of medical management failure. Studies in adults have shown that after interposition, the colon behaves in a similar way to the reversed small intestinal segement [4]. The technique may be performed iso-or antiperistatically [65].…”

“…Children with PSBS are usually dependent on parenteral nutrition (PN) to compensate fluid, electrolyte and energy requirements [1]. The causes of PSBS vary according to age; in neonates, predominant causes include necrotizing enterocolitis, small bowel atresia and gastroschisis, complicated meconium ileus, and midgut volvulus [4][5][6]. According to most studies, necrotizing enterocolitis is the most common cause of PSBS in the neonatal period, particularly among extremely premature infants, with an incidence rate ranging from 14% to 43% [4,7].…”

“…The causes of PSBS vary according to age; in neonates, predominant causes include necrotizing enterocolitis, small bowel atresia and gastroschisis, complicated meconium ileus, and midgut volvulus [4][5][6]. According to most studies, necrotizing enterocolitis is the most common cause of PSBS in the neonatal period, particularly among extremely premature infants, with an incidence rate ranging from 14% to 43% [4,7]. In older children, PSBS may be ascribed to Crohn's disease, abdominal tumors, radiation enteritis, trauma, malignancy, iatrogenic lesions and adhesive obstruction [8,9].…”

Models of Short Bowel Syndrome in Pigs: A Technical Review

“…Short bowel syndrome (SBS) is generally defined as a disorder in which the resorptive capacity of the intestine is not sufficient to provide an adequate alimentary supply due to anatomical or functional reasons [1,2]. The incidence of SBS is increasing [3] and varies between 2 and 5 patients per million [1,2,4].…”