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Surgical options for short bowel syndrome
1Division of Pediatric Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama 35233, USA.
Insights
Most children with short bowel syndrome adapt spontaneously, avoiding parenteral nutrition. For those who don't, surgical options promote intestinal adaptation and lengthening, offering a less invasive alternative to transplantation despite high complication rates.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Intestinal Adaptation
Background:
- Short bowel syndrome (SBS) is a condition where the small intestine is too short to absorb adequate nutrients.
- Most children with SBS achieve spontaneous intestinal adaptation, enabling weaning from parenteral nutrition (PN).
- A subset of children with SBS do not adapt sufficiently and require interventions to improve nutrient absorption.
Purpose of the Study:
- To describe surgical therapeutic options for promoting intestinal adaptation and lengthening in children with SBS.
- To review the existing literature on surgical interventions for SBS.
- To evaluate the reported outcomes of surgical procedures in pediatric SBS patients.
Main Methods:
- Literature review of surgical techniques for short bowel syndrome.
- Evaluation of reported results from surgical interventions.
- Analysis of complication and failure rates associated with surgical procedures.
Main Results:
- Surgical procedures for pediatric short bowel syndrome carry significant complication and failure rates.
- Despite risks, surgical interventions are generally less invasive than intestinal transplantation.
- These techniques aim to enhance intestinal adaptation and length for improved nutrient absorption.
Conclusions:
- Surgical options are considered for children with SBS who cannot be weaned from parenteral nutrition.
- While associated with risks, surgical interventions offer a pathway to improved intestinal function.
- These methods provide a less invasive alternative compared to intestinal transplantation for select pediatric patients.
Abstract:
Most children with short bowel syndrome experience spontaneous small bowel adaptation over time. This allows the majority to be weaned from parenteral nutrition. There are, however, some children who cannot be weaned and are potential candidates for techniques to promote intestinal adaptation and intestinal lengthening. Here, surgical therapeutic options are described, literature reviewed, and reported results evaluated. Surgical procedures for children with short bowel syndrome have high complication and failure rates, but in most cases are a less invasive option than intestinal transplantation.