Serial transverse enteroplasty in adults with parenteral nutrition dependence: A case series.

Autor: Mlaver E; Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA., Smith SR; Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA., Matar AJ; Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA., Zhao VM; Department of Pharmaceutical Services, Emory University Hospital, Atlanta, Georgia, USA., Leong R; Department of Pharmaceutical Services, Emory University Hospital, Atlanta, Georgia, USA., Sharma J; Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA., Srinivasan JK; Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA., Galloway JR; Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.; Department of Pharmaceutical Services, Emory University Hospital, Atlanta, Georgia, USA.
Jazyk: angličtina
Zdroj: JPEN. Journal of parenteral and enteral nutrition [JPEN J Parenter Enteral Nutr] 2024 Nov; Vol. 48 (8), pp. 965-973. Date of Electronic Publication: 2024 Sep 02.
DOI: 10.1002/jpen.2682
Abstrakt: Background: Serial transverse enteroplasty is used to treat patients with chronic intestinal failure owing to short bowel syndrome. Current literature lacks discussion of its role for other etiologies of intestinal failure and its impact on adult patients' nutrition support needs and quality of life.
Methods: We performed a case series on adults with parenteral nutrition (PN) dependence who underwent serial transverse enteroplasty at Emory University Hospital, a quaternary referral center between 2011 and 2022. Data collected included demographics, operative technique, and preoperative and postoperative PN requirements. A phone survey was administered to evaluate the impact of PN and the operation on quality of life.
Results: Ten patients underwent the procedure of interest during the study period. Indications included short bowel syndrome following multiple abdominal operations or intra-abdominal catastrophe and chronic partial bowel obstruction with dysmotility. Bowel length increased by a median of 83%. All patients were discharged home after a median hospital stay of 21 days. At 1-year follow-up, survival was 100%, two (20%) patients fully weaned from PN, three others (30%) reduced PN frequency, and six (60%) decreased their daily parenteral energy requirement. Two additional patients fully weaned from PN by 18 months postoperatively.
Conclusion: This represents one of the largest case series of serial transverse enteroplasty in adults. Small intestinal length nearly doubled, and PN dependence was reduced in most patients. Given the low morbidity and good quality of life observed in this series, this procedure should be more widely investigated for patients with chronic intestinal failure.
(© 2024 American Society for Parenteral and Enteral Nutrition.)
Databáze: MEDLINE
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