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Factors influencing enteral autonomy after autologous gastrointestinal reconstructive surgery: A two-centre UK perspective.
Cardoso Almeida, Andre; Skerritt, Clare; Cooper, Eden; Wiskin, Anthony; Wong, Theodoric; Garrett-Cox, Robin; Jester, Ingo.
Afiliación
  • Cardoso Almeida A; Department of Paediatric Surgery, Birmingham Women's and Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Department of Paediatric Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Upper Maudlin Street, Bristol, United Kingdom. Electronic address: andre.card
  • Skerritt C; Department of Paediatric Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Upper Maudlin Street, Bristol, United Kingdom.
  • Cooper E; School of Medicine, University of Birmingham, Birmingham, United Kingdom.
  • Wiskin A; Department of Paediatric Gastroenterology, University Hospitals Bristol and Weston NHS Foundation Trust, United Kingdom.
  • Wong T; Department of Paediatric Gastroenterology, Birmingham Women's and Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom.
  • Garrett-Cox R; Department of Paediatric Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Upper Maudlin Street, Bristol, United Kingdom.
  • Jester I; Department of Paediatric Surgery, Birmingham Women's and Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom.
J Pediatr Surg ; 58(2): 223-227, 2023 Feb.
Article en En | MEDLINE | ID: mdl-36404184
BACKGROUND AND AIMS: The implementation of multidisciplinary care and improvements in parenteral nutrition (PN) in patients with short bowel syndrome (SBS) have led to better outcomes and higher survivability. Autologous gastrointestinal reconstructive (AGIR) surgery can reduce the duration on PN and lead to earlier enteral autonomy (EA). Our aim was to investigate the effect of SBS aetiology and other predictors on the achievement of enteral autonomy following AGIR surgery. METHODS: Retrospective review of all patients undergoing AGIR surgery in two tertiary paediatric surgical units, between 2010 and 2021. Continuous data is presented as median (range). RESULTS: Twenty-seven patients underwent 29 AGIR procedures (20 serial transverse enteroplasties (STEP), 9 longitudinal intestinal lengthening and tailoring (LILT)) at an age of 6.6 months (1.5 - 104.5). EA rate was 44% at 13.6 months after surgery (1 - 32.8). AGIR procedures achieved an increase in small bowel length of 70% (pre-operative 46.5 vs 77 cm, p = 0.003). No difference was found between STEP and LILT (p = 0.84). Percentage of expected small bowel length (based on the child's weight) was a strong predictor of EA (bowel length >15% - EA 80% vs bowel length ≤15% - EA 17%, p = 0.008). A diagnosis of gastroschisis showed a negative non-significant correlation with the ability to achieve EA (25% vs 60%, p = 0.12). Overall survival rate was 96%. CONCLUSION: AGIR surgery is an important tool in the multidisciplinary management of children with SBS. Percentage of expected small length and aetiology of SBS are likely predictors of achievement of EA in patients undergoing AGIR surgery. LEVEL OF EVIDENCE: IV: Retrospective Case-Series.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome del Intestino Corto / Cirugía Plástica Tipo de estudio: Prognostic_studies Límite: Child / Humans / Infant País/Región como asunto: Europa Idioma: En Revista: J Pediatr Surg Año: 2023 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 / Cirugía Plástica Tipo de estudio: Prognostic_studies Límite: Child / Humans / Infant País/Región como asunto: Europa Idioma: En Revista: J Pediatr Surg Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos