小児患者における短腸症候群の治療成績

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).

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).

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).

Colon and ileocecal valve preservation are key prognostic factors improving outcomes and reducing hospitalisation in paediatric short bowel syndrome.