Format

Send to

Choose Destination
See comment in PubMed Commons below
J Pediatr. 2004 Aug;145(2):157-63.

Long-term parenteral nutritional support and intestinal adaptation in children with short bowel syndrome: a 25-year experience.

Author information

1
Division of Gastroenterology and Nutrition, UCLA Medical Center, Los Angeles, California, USA. rquiros@bcm.tmc.edu

Abstract

OBJECTIVE:

To analyze the outcome of children with short bowel syndrome (SBS) who required long-term parenteral nutrition (PN).

STUDY DESIGN:

Retrospective analysis of children (n=78) with SBS who required PN >3 months from 1975 to 2000.

STATISTICS:

univariate analysis, Kaplan-Meier method, and Cox proportional regression model were used.

RESULTS:

We identified 78 patients. Survival was better with small bowel length (SBL) >38 cm, intact ileocecal valve (ICV), intact colon, takedown surgery after ostomy (all P <.01), and primary anastomosis (P <.001). PN-associated early persistent cholestatic jaundice (P <.001) and SBL of <15 cm (P <.01) were associated with a higher mortality. Intestinal adaptation was less likely if SBL <15 cm (P <.05), ICV was removed, colonic resection was done (both P <.001), >50% of colon was resected (P <.05), and primary anastomosis could not be accomplished (P <.01). Survival was 73% (57), and 77% (44) of survivors had intestinal adaptation.

CONCLUSIONS:

SBL, intact ICV, intestinal continuity, and preservation of the colon are important factors for survival and adaptation. Adaptation usually occurred within the first 3 years. Need for long-term PN does not preclude achieving productive adulthood. Patients with ICV even with <15 cm of SBL and patients with SBL >15 cm without ICV have a chance of intestinal adaptation.

PMID:
15289760
DOI:
10.1016/j.jpeds.2004.02.030
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center