The SickleFit Tele-Exercise Program for older adults with sickle cell disease: feasibility, acceptability, safety study.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Keet Corinne, Sicherer Scott H, Bunyavanich Supinda, Visness Cynthia, Fulkerson Patricia C, Togias Alkis, Davidson Wendy, Perry Susan, Hamrah Sanaz, Calatroni Agustin, Robinson Katina, Dunaway Lars, Davis Carla M, Anvari Sara, Leong-Kee Susan M, Hershey Gurjit Khurana, DeFranco Emily, Devonshire Ashley, Kim Haejin, Joseph Christine, Davidson Brent, Strong Noel K, Tsuang Angela J, Groetch Marion, Wang Julie, Dantzer Jennifer, Mudd Kim, Aina Abimbola, Shreffler Wayne, Yuan Qian, Simmons Virginia, Leung Donald Y M, Hui-Beckman Jessica, Ramos Jania Arcia, Chinthrajah Sharon, Winn Virginia, Sindher Tina, Jones Stacie M, Manning Nirvana A, Scurlock Amy M, Kim Edwin, Stuebe Alison, Gern James E, Singh Anne Marie, Krupp Jennifer, Wood Robert A
Аннотация
METHODS: Beginning in May 2021 prospective candidate children were identified. Candidacy for ileal tube lengthening included diagnosis of ultrashort bowel syndrome, intact ileocecal valve with remnant ileum, and proximal intestinal stoma or draining gastrostomy. Informed consent was obtained. Following laparoscopic lysis of adhesions, a balloon catheter was inserted through a left flank stab incision and into the lumen of the remnant ileum around a purse string suture. Cecopexy was performed in the right-lower quadrant. Clips were used to mark the cecum and the proximal extent of ileum. The catheter length was fixed externally at the completion of the procedure. Serial x-rays were used to measure distraction effect while increasing tension was applied to the catheter over the subsequent weeks. Ileal tube lengthening was performed until the end of the catheter was reached or the tube was dislodged. A contrast study was performed at the completion of lengthening. Intestinal length at time of restoration of continuity and clinical outcomes were recorded.
RESULTS: Four infants were enrolled from May 2021-July 2023. Diagnoses leading to ultrashort bowel syndrome were mesenteric teratoma, necrotizing enterocolitis, and multiple intestinal atresia. At the time of restoration of intestinal continuity, a median of 1.75 cm (45 %) additional ileal length was achieved at a median of 25.5 days. There were no serious complications following ileal tube lengthening and no additional operative interventions were required.
CONCLUSIONS: Ileal lengthening through internal distraction is a feasible surgical intervention to salvage ileum for infants with ultrashort bowel syndrome. Ileal tube lengthening may result in distraction enterogenesis, providing a novel intervention to increase intestinal length.
LEVEL OF EVIDENCE: IV (Case series without comparison group).