Surgical Approaches to Improving Intestinal Function in the Short-Bowel Syndrome

Thompson, Jon S.; Langnas, Alan Norman

doi:10.1001/archsurg.134.7.706

Cited by 47 publications

(26 citation statements)

References 14 publications

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“…Posteriormente tiveram bons resultados no tratamento cirúrgico em humanos. Após esse estudo, a técnica foi utilizada por outros autores com resultados animadores relatados 26 . Experiências clínicas com o uso de válvulas intestinais como a válvula de "nipple" (tipo mamilar) ainda são bem limitadas 29 e podem causar obstrução intestinal e intussuscepção.…”

Section: Discussionunclassified

“…Os papéis dos hormônios implicados como agentes tróficos administrados sistematicamente como o hormônio do crescimento, enteroglucagon, fator de crescimento insulina-like e a glutamina estão sendo avaliados com insuficientes evidências clínicas descritas 4,8,14,15,16,20,21,28,31 . Numerosas estratégias cirúrgicas foram tentadas em pacientes cronicamente dependentes de NPT 21,24,25,26,29,30 . Procedimentos para retardar o tempo de trânsito intestinal permitindo tempo adicional de contato para a absorção de nutrientes e líquidos como a construção de válvulas e esfíncteres tem sido descritos, porém com resultados inconsistentes relatados.…”

Section: Introductionunclassified

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Síndrome do intestino curto: uma nova alternativa de tratamento cirúrgico

Franzon¹,

Suzuki²,

Sato³

et al. 2010

ABCD, arq. bras. cir. dig.

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DESCRITORES -Síndrome do intestino curto. Nutrição parenteral total. Cirurgia.RESUMO -Introdução -A síndrome do intestino curto resulta de comprimento total de intestino delgado inadequado para manter a nutrição, e assim, os pacientes tornam-se cronicamente dependentes de nutrição parenteral total. Numerosas estratégias cirúrgicas foram estudadas para restabelecer a função intestinal normal. Objetivo -Propor a utilização da inversão de segmento de alça associada à STEP -Serial Transverse Enteroplasty -para aumentar a área absortiva intestinal em pacientes com síndrome do intestino curto. Método -Os autores descrevem uma nova alternativa para o tratamento cirúrgico da síndrome do intestino curto, demonstrando sua facilidade e eficiência para o objetivo proposto. Resultados -As duas técnicas associadas permitiram alongar a alça intestinal em 2,6 vezes do comprimento original, com posterior ganho de peso, redução do número de evacuações para uma exoneração ao dia e melhora da qualidade de vida social e psicológica. Conclusão -Essa técnica de inversão de segmento de alça intestinal e posterior STEP surge como tratamento eficiente e definitivo à síndrome do intestino curto de forma promissora e segura permitindo retorno à alimentação por via oral com satisfatória absorção de nutrientes e ganho de peso, retorno da motilidade efetiva intestinal, associada à baixa morbidade e melhoria da qualidade de vida social e psicológica. Apesar de requerer várias cargas de grampeadores lineares apresenta baixa morbidade e passa a tornar-se um potencial substituto para o transplante intestinal.ABSTRACT -Background -The short bowel syndrome results of inadequate total length of small intestine that is not enough to nutrition, and so, the patients become dependents of total parenteral nutrition. Numerous surgical strategies had been studied to reestablish the normal intestinal function. ObjectiveConsider the inversion segment of small intestine associated with STEP -Serial Transverse Enteroplasty -to increase the intestinal absorptive area in patients with short bowel syndrome. Method -The authors describe a new alternative for surgical treatment of short bowel syndrome, demonstrating it's easiness and efficiency for the considered objective. Results -The two techniques associated, had allowed lengthening the small intestine in 2,6 times the original length, with posterior profit of weight, reduction the number of evacuations. ConclusionThis technique of inversion segment of small intestine and posterior STEP is efficient, appears as definitive and promising technique of treatment to short bowel syndrome allowing return to oral feeding, with satisfactory absorption of nutrients, return to normal intestinal movement, associated to low morbidity and improvement the quality of social and psychological life. It presents low morbidity and is a potential substitute to intestinal transplant. INTRODUÇÃOA síndrome do intestino curto (SIC) resulta de um comprimento total de intestino delgado que é inadequado para manter a nutrição via oral sat...

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Section: Discussionunclassified

Section: Introductionunclassified

Síndrome do intestino curto: uma nova alternativa de tratamento cirúrgico

Franzon¹,

Suzuki²,

Sato³

et al. 2010

ABCD, arq. bras. cir. dig.

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“…Non-transplant surgical approaches for SBS include lengthening of the small intestine, artificial intestinal valve construction, colon interposition, and segmental reversal of the small bowel (SRSB) [3, 5, 6]. It has been reported that SRSB compares favorably with other reconstructive surgical procedures proposed for the treatment of SBS [3].…”

Section: Discussionmentioning

confidence: 99%

“…Although improvements in surgical procedure and advances in parenteral nutrition (PN) have led to the increased survival of patients with SBS [2, 3, 4], clinical problems involving malnutrition or infection still remain. Surgical options include lengthening of the small intestine, artificial intestinal valve construction, colon interposition, segmental reversal of the small bowel [3, 5, 6]and also intestinal transplantation [7]. The goal of the non-transplant surgical procedure is to expand the intestinal surface area or to improve the function of the intestinal remnant.…”

Section: Introductionmentioning

confidence: 99%

Interposed Colon between Remnants of the Small Intestine Exhibits Small Bowel Features in a Patient with Short Bowel Syndrome

Kono¹,

Sekikawa²,

Iizuka³

et al. 2001

Dig Surg

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We describe herein the case of a 48-year-old man who underwent emergency massive resection of the small intestine due to a strangulated ileus, which led to short bowel syndrome (SBS), as he was left with only 7 cm of jejunum and 8 cm of ileum with ileocecal valve. He then received interposition of a colon segment between the jejunum and ileum remnants isoperistaltically. For 24 months after the operation, he has been able to tolerate oral intake, but still requires partial home parenteral nutritional support during the night on a bimonthly basis. Biochemical and nutritional parameters, including the analysis of minerals and trace elements, indicated that the patient was in relatively good health. Histological examination revealed that the mucosa of the interposed colon showed hypertrophy and hyperplasia of the crypt glands, and cells resembling Paneth cells which are usually seen in the small intestine, suggesting that the colon segment exhibits adaptive changes to the small intestine. Colon interposition may be a useful technique in patients with SBS when the small bowel is too short for the other surgical considerations.

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“…Several surgical interventions have been attempted in order to improve absorptive function, mainly in pediatric short-bowel patients [25]. Intestinal lengthening by duplication, generation of recirculating loop, or reversal of a short intestinal segment to delay transit are some of the procedures that have been used, but generally, with limited success [26,27].…”

Section: Opinion Statementmentioning

confidence: 99%

Short-bowel syndrome

Westergaard

2000

Curr Treat Options Gastro

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Surgical Approaches to Improving Intestinal Function in the Short-Bowel Syndrome

Cited by 47 publications

References 14 publications

Síndrome do intestino curto: uma nova alternativa de tratamento cirúrgico

Síndrome do intestino curto: uma nova alternativa de tratamento cirúrgico

Interposed Colon between Remnants of the Small Intestine Exhibits Small Bowel Features in a Patient with Short Bowel Syndrome

Short-bowel syndrome

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