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Radiographic measurement of intestinal length among children with short bowel syndrome: Retrospective determination remains problematic.
Velazco, Cristine S; Fullerton, Brenna S; Brazzo, Joseph A; Hong, Charles R; Jaksic, Tom; Barnewolt, Carol E.
Afiliación
  • Velazco CS; Center for Advanced Intestinal Rehabilitation, Boston Children's Hospital, Boston, MA; Department of Surgery Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
  • Fullerton BS; Center for Advanced Intestinal Rehabilitation, Boston Children's Hospital, Boston, MA; Department of Surgery Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
  • Brazzo JA; Department of Surgery Boston Children's Hospital, Boston, MA.
  • Hong CR; Center for Advanced Intestinal Rehabilitation, Boston Children's Hospital, Boston, MA; Department of Surgery Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
  • Jaksic T; Center for Advanced Intestinal Rehabilitation, Boston Children's Hospital, Boston, MA; Department of Surgery Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
  • Barnewolt CE; Department of Radiology, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA. Electronic address: carol.barnewolt@childrens.harvard.edu.
J Pediatr Surg ; 52(12): 1921-1924, 2017 Dec.
Article en En | MEDLINE | ID: mdl-28987713
PURPOSE: Small bowel length is the most reliable predictor of enteral independence in pediatric short bowel syndrome. Retrospectively measured bowel lengths on upper GI with small bowel follow-through (UGI/SBFT) were compared to operative measurements. METHODS: A pediatric radiologist and surgical trainees blinded to operative measurements retrospectively analyzed UGI/SBFT studies using the digital radiography curved measurement tool. Children with SBS and severe intestinal failure (parenteral nutrition >90days) at a multidisciplinary intestinal failure program 2002-2015 were included. Data were expressed as median (Q1, Q3). RESULTS: Thirty-six children aged 0.8 (0.4, 3.7) years were analyzed. Fifty-six percent had intestinal malrotation, and 58% had prior serial transverse enteroplasty. Studies were conducted within 10 (7, 20) days of surgery. Intraoperative bowel length was 90cm (45, 142), while UGI/SBFT measurement by radiologist was 45cm (28, 63), with a mean difference of 47cm (SD 58cm, p<0.001) and a mean percent error of 50%. Radiographic assessment underestimated intestinal length in 83% of patients. CONCLUSION: Bowel length measured retrospectively from upper GI with small bowel follow-through studies usually underestimated intraoperative bowel length. The limits of agreement were too wide for this technique to be clinically useful. Operative measurement remains necessary to assess intestinal length and rehabilitation potential. TYPE OF STUDY: Study of Diagnostic Test. LEVEL OF EVIDENCE: Level III.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome del Intestino Corto / Atresia Intestinal / Intestino Delgado Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: J Pediatr Surg Año: 2017 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome del Intestino Corto / Atresia Intestinal / Intestino Delgado Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: J Pediatr Surg Año: 2017 Tipo del documento: Article Pais de publicación: Estados Unidos