Back to Search
Start Over
Repeat serial transverse enteroplasty leads to reduction in parenteral nutrition in children with short bowel syndrome.
- Source :
-
Journal of pediatric surgery [J Pediatr Surg] 2021 Apr; Vol. 56 (4), pp. 733-737. Date of Electronic Publication: 2020 Jul 10. - Publication Year :
- 2021
-
Abstract
- Background/purpose: Following a serial transverse enteroplasty (STEP) procedure some children develop redilation of the small intestine leading to impaired enteral tolerance and inability to wean parenteral nutrition (PN). The benefit of a second STEP procedure (2STEP) has been controversial.<br />Methods: We performed a retrospective review of our experience (2008-2018) performing 2STEP, with comparative analysis of nutritional outcomes pre- and postsurgery.<br />Results: During this period 2STEP was performed in 23 patients (13 F:10 M) at a median (25%-75%) age of 2.2 (1.2-3.6) years. Median intestinal length was 68 (40-105) cm before and 85 (40-128) cm after 2STEP. Leading up to 2STEP, PN provided almost 75% of estimated calorie needs. By 24 weeks following 2STEP drops in mean PN percent approached statistical significance (p = 0.07) and at most recent follow up the mean PN percentage was statistically better than at the time of operation or 4 weeks prior to 2STEP, and was nearly significant compared with 12 weeks (p = 0.07) and 24 weeks (p = 0.06) prior. Thirteen children were completely off parenteral support.<br />Conclusion: When small intestine redilation occurs following a STEP procedure and where PN cannot otherwise be weaned we believe these data support performing a 2STEP. We cannot predict preoperatively which children will ultimately benefit.<br />Level of Evidence: 3 (retrospective comparative study).<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 1531-5037
- Volume :
- 56
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of pediatric surgery
- Publication Type :
- Academic Journal
- Accession number :
- 32736789
- Full Text :
- https://doi.org/10.1016/j.jpedsurg.2020.06.045