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Serial transverse enteroplasty for short bowel syndrome: Hong Kong experience
Michael W Y Leung1, Ivy H Y Chan, Nicholas S Y Chao
1Division of Paediatric Surgery, Department of Surgery, Queen Elizabeth Hospital, 30 Gascoigne Road, Hong Kong. leungwym@ha.org.hk
Objective:
To report our experience with the first series of serial transverse enteroplasty operations (a novel bowel-lengthening procedure for patients with short bowel syndrome). DESIGN. Case series.
Setting:
A tertiary paediatric surgery referral centre in Hong Kong.
Patients:
Four patients with short bowel syndrome aged 11 months to 14 years underwent serial transverse enteroplasty between November 2007 and June 2010.
Results:
A total of six such serial procedures were performed; two patients had repeated operations. Median pre-serial transverse enteroplasty small bowel length was 17.5 cm. The median increase in small bowel length was 90%. One patient experienced transient postoperative intestinal obstruction that resolved after conservative management. The median postoperative follow-up period was 31 months. The median enteral nutrition tolerance increased from 24% to 47%. The median weight-for-age z score increased by 0.55, and the median weight-for-height z score increased by 0.98. One patient had successfully weaned off parenteral nutrition.
Conclusion:
Serial transverse enteroplasty is a feasible and safe treatment for short bowel syndrome patients, which helps to improve enteral nutrition and promote growth. Repeated serial transverse enteroplasty can be performed in patients with ultra-short bowel lengths. Follow-up is necessary to assess the long-term outcomes.
