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World Journal of Surgery

Published in:

01-07-2013

Early Structured Surgical Management Plan for Neonates with Short Bowel Syndrome May Improve Outcomes

Authors: S. J. Wood, B. Khalil, F. Fusaro, S. E. Folaranmi, S. A. Sparks, A. Morabito

Published in: World Journal of Surgery | Issue 7/2013

Abstract

Background

In children with short bowel syndrome, maximal adaptation of the bowel after extensive resection is thought to occur during the first 2 years of life. The aim of the present study was to review children with short bowel syndrome from two intestinal rehabilitation centers, comparing those undergoing lengthening procedures <365 days of age (early) versus those whose lengthening procedure was carried out >365 days of age (late).

Methods

Retrospective data collection was performed from January 2004 to December 2010 in Manchester, UK, and from December 2006 to December 2010 in Brussels, Belgium. Both medical centers follow a similar intestinal rehabilitation program (IRP). Data collected included population demographics, bowel length preoperatively and postoperatively, age at operation, parenteral nutrition (PN), central access, and complications.

Results

Complete data were available for eight children who underwent lengthening surgery at <365 days of age, and six who underwent the procedure at >365 days of age. Diagnoses were similar. Groups were matched for gestation and birthweight, with no statistical difference in preoperative and postoperative bowel lengths. The mean duration of PN postoperatively was 378 days in the early cohort and 589 days in the late cohort. This trended toward statistical significance (p = 0.071). Full enteral autonomy was achieved at 17 months (early) and 59 months (late) (p = 0.01). Patients in the early group required fewer central lines than those operated on later (p = 0.035).

Conclusions

Enrolling children into an IRP involving early (<365 days of age) lengthening surgery allows a shorter postoperative time to allow weaning to full enteral nutrition, as well as fewer central lines. Both outcomes provide benefits for the child and family, allowing an earlier return to normal life.

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Title: Early Structured Surgical Management Plan for Neonates with Short Bowel Syndrome May Improve Outcomes
Authors: S. J. Wood
B. Khalil
F. Fusaro
S. E. Folaranmi
S. A. Sparks
A. Morabito
Publication date: 01-07-2013
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 7/2013
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-013-2011-z

At a glance: The STEP trials

Springer Medicine

Early Structured Surgical Management Plan for Neonates with Short Bowel Syndrome May Improve Outcomes

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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