MedElevator
Войти в исследования European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie · 2018
Institutional Experience with Spiral Intestinal Lengthening and Tailoring.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
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.
Coletta Riccardo, Aldeiri Bashar, Morabito Antonino
Аннотация
AIM: The aim of this study was to report our initial experience using spiral intestinal lengthening and tailoring (SILT) technique in selected cases of short bowel syndrome (SBS).
MATERIALS AND METHODS: We analyzed all cases of SBS underwent SILT in our unit since the introduction of the procedure in 2012. We retrospectively analyzed patients' demographics, pre- and postprocedure bowel length, surgical complications, and postoperative parenteral nutrition (PN) requirements. Data were compared using independent samples, Mann-Whitney's U-test.
RESULTS: Five children with SBS underwent SILT between 2012 and 2017. Median age at procedure was 8.3 months (4.5-16). Preoperative small bowel length measured a median of 22 cm (17.5-50) with a median diameter of 4 cm (3.5-4.6). SILT allowed a median increase in length of 56% (10-15 cm; p = 0.03) and tailoring of the dilated segment providing a reduction in diameter of 50% (4.3-2.1 cm; p = 0.01). No major complications related to SILT were encountered and none of the children required further surgical intervention following a median follow-up of 26 months (14.5-41). Interestingly, we observed a significant reduction of PN requirement at 6 months (p = 0.008) associated with liver function preservation during the follow-up period.
CONCLUSION: In our experience, SILT is a promising adjunct in the surgical management of SBS. It can be used to tailor and lengthen mildly dilated segments of the bowel where other procedures are technically challenging, with a view to reduce the risk of intestinal failure associated liver disease and thereby improving chances for quality survival. Further studies are needed to investigate long-term outcomes of SILT in pediatric SBS.
MATERIALS AND METHODS: We analyzed all cases of SBS underwent SILT in our unit since the introduction of the procedure in 2012. We retrospectively analyzed patients' demographics, pre- and postprocedure bowel length, surgical complications, and postoperative parenteral nutrition (PN) requirements. Data were compared using independent samples, Mann-Whitney's U-test.
RESULTS: Five children with SBS underwent SILT between 2012 and 2017. Median age at procedure was 8.3 months (4.5-16). Preoperative small bowel length measured a median of 22 cm (17.5-50) with a median diameter of 4 cm (3.5-4.6). SILT allowed a median increase in length of 56% (10-15 cm; p = 0.03) and tailoring of the dilated segment providing a reduction in diameter of 50% (4.3-2.1 cm; p = 0.01). No major complications related to SILT were encountered and none of the children required further surgical intervention following a median follow-up of 26 months (14.5-41). Interestingly, we observed a significant reduction of PN requirement at 6 months (p = 0.008) associated with liver function preservation during the follow-up period.
CONCLUSION: In our experience, SILT is a promising adjunct in the surgical management of SBS. It can be used to tailor and lengthen mildly dilated segments of the bowel where other procedures are technically challenging, with a view to reduce the risk of intestinal failure associated liver disease and thereby improving chances for quality survival. Further studies are needed to investigate long-term outcomes of SILT in pediatric SBS.