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Treatment Outcomes of Short Bowel Syndrome in Paediatric Patients
Ha Huy Khoi1, Ngo van Bach2,3, Dang Hoang Khanh Duy4
1Phongkhamnhidrthieu, Ho Chi Minh City, Vietnam.
Insights
Preserving the colon and ileocecal valve (ICV) significantly improves treatment success in children with short bowel syndrome (SBS). Maintaining adequate residual small bowel length (RSBL) is crucial for positive outcomes in pediatric SBS patients.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Clinical Outcomes Research
Background:
- Short bowel syndrome (SBS) is a complex condition requiring surgical intervention.
- Intestinal anatomy, including residual small bowel length (RSBL) and ileocecal valve (ICV) status, is critical in SBS management.
- Understanding the prognostic value of anatomical characteristics is essential for optimizing pediatric SBS care.
Purpose of the Study:
- To evaluate the association between specific intestinal anatomical features and treatment outcomes in pediatric patients with SBS.
- To determine the impact of resected bowel segment, residual small bowel length (RSBL), and ileocecal valve (ICV) preservation on SBS treatment success.
- To identify key prognostic factors for improving outcomes and reducing hospitalization in pediatric SBS.
Main Methods:
- A retrospective analysis of 35 pediatric SBS patients who underwent small bowel resection between July 2021 and July 2024.
- Definition of SBS based on RSBL ≤25% of expected length or dependence on parenteral nutrition ≥60 days.
- Categorization of treatment outcomes into successful (stabilization, discharge) or unsuccessful (death, lack of improvement).
Main Results:
- The overall treatment success rate was 60%, with 40% experiencing mortality or failure.
- Significantly longer mean RSBL in the success group (86.1 cm) compared to the failure group (52.7 cm; p < 0.001).
- Preservation of both the colon and ICV was significantly associated with treatment success (p < 0.05), and absence of ICV preservation led to longer hospital stays.
Conclusions:
- Colon and ileocecal valve (ICV) preservation are key prognostic factors for improving outcomes in pediatric short bowel syndrome (SBS).
- Maintaining adequate residual small bowel length (RSBL) is critical for successful treatment and reducing mortality in pediatric SBS.
- Preserving intestinal anatomical structures like the colon and ICV can reduce hospitalization duration and enhance overall patient recovery.
Objective:
This study evaluated the association between intestinal anatomical characteristics-including the resected bowel segment, residual small bowel length (RSBL), and preservation of the ileocecal valve (ICV)-and treatment outcomes in children with short bowel syndrome (SBS).
Methods:
A retrospective study was conducted of 35 paediatric SBS patients who underwent small bowel resection at the study site from July 2021 to July 2024. SBS was defined by an RSBL ≤ 25% of the expected length for age or dependence on parenteral nutrition ≥ 60 days. Treatment outcomes were categorised as successful (clinical stabilisation and discharge) or unsuccessful (death or lack of improvement).
Results:
Most patients underwent surgery during the neonatal period (91.4%). A majority had RSBL > 38 cm (88.6%), preserved ICV (74.2%), and intact colon (67.7%). The overall treatment success rate was 60% (n = 21), while mortality or failure occurred in 40% (n = 14). The mean RSBL in the success group (86.1 ± 28.1 cm) was significantly longer than in the failure group (52.7 ± 24.9 cm; p < 0.001). All patients with very short (15-38 cm) or ultra-short (< 15 cm) RSBL experienced treatment failure or death (p < 0.05). Preservation of both the colon and ICV was significantly associated with treatment success (p < 0.05). Patients without ICV preservation had longer median hospital stays than those with ICV preservation (126 days vs. 100.5 days; p < 0.05).
Conclusion:
Colon and ileocecal valve preservation are key prognostic factors improving outcomes and reducing hospitalisation in paediatric short bowel syndrome.
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