Colonic segment reversal: A potential surgical option for selected children with short bowel syndrome.

OBJECTIVE

To evaluate the clinical value and efficacy of colonic segment reversal in children with short bowel syndrome (SBS).

METHODS

A retrospective review was conducted on 11 children with SBS who underwent colonic segment reversal at our center between January 2016 and October 2025. Postoperative intestinal transit time, weaning rate from parenteral nutrition (PN), and growth parameters (weight-for-age z-score, WAZ), complications, and frequency of small intestinal bacterial overgrowth (SIBO) were evaluated.

RESULTS

Eleven children (8 males, 3 females) underwent colonic reversal. The overall survival rate was 100% (11/11), and the PN weaning rate was 63.6% (7/11). The median time to PN weaning was 3 months. Postoperative intestinal transit time was prolonged compared with preoperative values (data available for 3 patients). The median preoperative WAZ was -1.85, which improved to -0.87 at 6 months postoperatively. Complications included one case of reversible intestinal obstruction and one case of anastomotic ulcer. The frequency of small intestinal bacterial overgrowth did not increase significantly.

CONCLUSION

Colonic segment reversal is a safe and effective surgical option for selected children with SBS, particularly when residual small bowel length is extremely limited. Surgical strategies should be individualized, taking into account residual bowel length, motility, and anatomical conditions.