Bowel Lengthening Procedures in Children with Short Bowel Syndrome: A Systematic Review
| Autor: | H. R. Langeveld, M. Y. van Poelgeest, Lucas Wessel, R. Bakx, Marc A. Benninga, Merit M. Tabbers, Annika Mutanen, Sjoerd C. J. Nagelkerke, Susan Hill |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Short Bowel Syndrome
Parenteral Nutrition Pediatrics medicine.medical_specialty Serial transverse enteroplasty Bianchi MEDLINE Patient characteristics 03 medical and health sciences 0302 clinical medicine intestinal failure medicine Humans Prospective Studies Child Digestive System Surgical Procedures Retrospective Studies business.industry Infant Newborn Infant Short bowel syndrome medicine.disease 3. Good health Review article Intestines longitudinal intestinal lengthening and tailoring Treatment Outcome Parenteral nutrition pediatric Child Preschool 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health serial transverse enteroplasty Treatment strategy 030211 gastroenterology & hepatology Surgery business Bowel lengthening |
| Zdroj: | European journal of pediatric surgery. |
| ISSN: | 0939-7248 |
| Popis: | Introduction The aims of the study are to systematically assess and critically appraise the evidence concerning two surgical techniques to lengthen the bowel in children with short bowel syndrome (SBS), namely, the longitudinal intestinal lengthening and tailoring (LILT) and serial transverse enteroplasty (STEP), and to identify patient characteristics associated with a favorable outcome. Materials and Methods MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched from inception till December 2019. No language restriction was used. Results In all, 2,390 articles were found, of which 40 were included, discussing 782 patients. The median age of the patients at the primary bowel lengthening procedure was 16 months (range: 1–84 months). Meta-analysis could not be performed due to the incomparability of the groups, due to heterogeneous definitions and outcome reporting. After STEP, 46% of patients weaned off parenteral nutrition (PN) versus 52% after LILT. Mortality was 7% for STEP and 26% for LILT. Patient characteristics predictive for success (weaning or survival) were discussed in nine studies showing differing results. Quality of reporting was considered poor to fair. Conclusion LILT and STEP are both valuable treatment strategies used in the management of pediatric SBS. However, currently it is not possible to advise surgeons on accurate patient selection and to predict the result of either intervention. Homogenous, prospective, outcome reporting is necessary, for which an international network is needed. |
| Databáze: | OpenAIRE |
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