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Early Bowel Lengthening Procedures: Bi-Institutional Experience and Review of the Literature

Elisa Negri1,2, Riccardo Coletta2,3, Lynette Forsythe4

  • 1Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, 50121 Florence, Italy.

Children (Basel, Switzerland)
|February 25, 2022
PubMed

Insights

Early bowel lengthening procedures (EBLP) are complex, with no clear consensus on indications or timing. This study suggests EBLP should be reserved for necessity and performed in specialized intestinal failure centers.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Intestinal Rehabilitation

Background:

  • Short bowel syndrome (SBS) is a significant challenge in pediatric care.
  • Early bowel lengthening procedures (EBLP) aim to improve intestinal length before six months of age.
  • Optimal timing and indications for EBLP remain debated.

Purpose of the Study:

  • To compare institutional experience with existing literature on early bowel lengthening procedures (EBLP).
  • To identify common indications and outcomes for EBLP.
  • To provide guidance on the appropriate use of EBLP.

Main Methods:

  • A bi-institutional retrospective analysis of EBLP cases.
  • Literature review of PubMed/Embase for bowel lengthening procedures over 40 years.
  • Analysis of diagnosis, surgical type, age, and outcomes.

Main Results:

  • Eleven EBLP cases analyzed, with a median age of 126 days and a median bowel length increase of 81%.
  • Literature search identified 61 EBLP cases, with a median age of 60 days.
  • Serial transverse enteroplasty (STEP) was the most common procedure, yielding a median length increase of 57%.

Conclusions:

  • There is no established consensus on the indications or optimal timing for EBLP.
  • EBLP should be considered only when strictly necessary.
  • Procedures should be performed in specialized intestinal failure centers.

Keywords:
autologous intestinal reconstructive surgeryearly bowel lengtheningshort bowel syndrome

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