Outcome and intestinal adaptation in neonatal short-bowel syndrome

Georgeson, Keith E.; Breaux, Charles W.

doi:10.1016/0022-3468(92)90859-6

Cited by 157 publications

(78 citation statements)

References 20 publications

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“…A significant proportion of patients with midgut volvulus secondary to malrotation undergo extensive resection of non-viable bowel; in some series up to 30% of cases with small bowel insufficiency syndrome are the direct results of malrotation volvulus [6][7][8]. The conventional management of patients with extensive gut necrosis consists of detorsion, resection of all non-viable bowel and either primary anastomosis or stoma formation.…”

Section: Discussionmentioning

confidence: 99%

Malrotation volvulus in a neonate: a novel surgical approach

Houben

Mitton²,

Capps³

2005

Ped Surgery Int

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A newborn presented with bilious vomiting secondary to a malrotation and presumed perinatal-onset volvulus. Laparotomy was performed at 20 h of age at which the volvulus was derotated. Nevertheless the small but not the large bowel appeared to be completely ischaemic and non-viable. A second-look laparotomy was performed 24 h later with no significant improvement. In a new approach to the problem, nothing further was done and the child was left alone on parenteral nutrition and naso-gastric aspiration for 11 weeks. Further exploration showed that 40 cm of small bowel had survived intact and restorative surgery was carried out. Parenteral nutrition was discontinued after 9 months and the child, now aged 3.5 years, is thriving.

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Section: Discussionmentioning

confidence: 99%

Malrotation volvulus in a neonate: a novel surgical approach

Houben

Mitton²,

Capps³

2005

Ped Surgery Int

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“…The question arises whether this procedure simply dilates the bow-Willis/Klosterhalfen/Titkova/Anurov/ Polivoda/Max/Öttinger/Schumpelick el, as occurs in acute or chronic bowel obstruction, or whether there is an increased intestinal adaptation with induction of real bowel growth [4,7], and whether this procedure could increase the absorptive capacity of the small intestinal remnant [8]. The present results show that the serosal diameter was unchanged in PRV, while it was significantly increased in DRV.…”

Section: Discussionmentioning

confidence: 99%

“…Artificial valves significantly improved transit Willis/Klosterhalfen/Titkova/Anurov/ Polivoda/Max/Öttinger/Schumpelick time, body weight and survival in rats [5], dogs [6][7][8] and humans [4]. However, it is still unclear whether this procedure simply dilates the bowel, as occurs in acute bowel obstruction, or whether real bowel growth is induced [4,9]. Therefore, the aims of this study were (1) to demonstrate and quantify morphological and functional changes after proximal and distal small-bowel resection in rats and (2) to examine whether this adaptive response could be further improved by artificial valves.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, to induce gut dilatation and subsequent growth, partial obstruction of the small intestine was perfomed using artificial valves in order to increase the absorptive mucosal surface [1,4]. Artificial valves significantly improved transit Willis/Klosterhalfen/Titkova/Anurov/ Polivoda/Max/Öttinger/Schumpelick time, body weight and survival in rats [5], dogs [6][7][8] and humans [4]. However, it is still unclear whether this procedure simply dilates the bowel, as occurs in acute bowel obstruction, or whether real bowel growth is induced [4,9].…”

Section: Introductionmentioning

confidence: 99%

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Effect of Artificial Valves on Intestinal Adaptation in the Short-Bowel Syndrome: An Integrated Study of Morphological and Functional Changes in Rats

Willis¹,

Klosterhalfen²,

Titkova

et al. 2000

Eur Surg Res

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Two-third-resections of the proximal or distal small bowel with and without artificial valves were performed in rats. Intestinal adaptation led to a significant increase in bowel diameter, villus height and villus diameter and consequently in absorptive mucosal surface area per unit of serosal area. Additional artificial valve construction did not affect the calculated mucosal surface area after proximal resection, while it significantly decreased the absorptive area by the occurrence of large, plump villi after distal resection. There was no change in small-intestinal absorption of water, glucose and electrolytes per unit mucosa with valve construction. DNA cytometry showed that artificial valves led to mucosal hyperplasia without hypertrophy. These morphological changes coincided with a significant increase in basal and stimulated gastrin release. The body weight was unchanged or even worse in the valve groups than after resection alone, despite a significantly prolonged transit time. Therefore, in our study, artificial valves did not result in functional improvements after small intestinal resections.

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“…Prevalvüler anostomoz yapma durumunda vasküler nedenler ve lümen içi yüksek basınç nedeni ile anastomoz güvenliği konusunda klasik kitaplarda yer alan bazı sakıncalar belirtilmiştir (3) . Ancak, bazı olgularda ileoçekal valvin korunması yaşamsal önem gösterebilir.…”

Section: Introductionunclassified