Short bowel syndrome surgery: Difference between revisions
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==Indications== | ==Indications== | ||
*Surgery is not the first-line treatment option for patients with short bowel syndrome. Surgery is usually reserved for patients with either: | *Surgery is not the first-line treatment option for patients with short bowel syndrome. Surgery is usually reserved for patients with either: | ||
** | **Complications | ||
**[Indication 2] | **[Indication 2] | ||
**[Indication 3] | **[Indication 3] | ||
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**Irreversible permanent total parenteral nutrition (TPN) requirement and loss of venous access | **Irreversible permanent total parenteral nutrition (TPN) requirement and loss of venous access | ||
==Contraindications== | ==Contraindications== | ||
* Transplant is contraindicated in patients with either:<ref name="EçaBarbosa2016">{{cite journal|last1=Eça|first1=Rosário|last2=Barbosa|first2=Elisabete|title=Short bowel syndrome: treatment options|journal=Journal of Coloproctology|volume=36|issue=4|year=2016|pages=262–272|issn=22379363|doi=10.1016/j.jcol.2016.07.002}}</ref> | * [[Organ transplant|Transplant]] is contraindicated in patients with either:<ref name="EçaBarbosa2016">{{cite journal|last1=Eça|first1=Rosário|last2=Barbosa|first2=Elisabete|title=Short bowel syndrome: treatment options|journal=Journal of Coloproctology|volume=36|issue=4|year=2016|pages=262–272|issn=22379363|doi=10.1016/j.jcol.2016.07.002}}</ref> | ||
** Absolute | ** Absolute | ||
*** Active infection | *** Active infection | ||
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==Surgery== | ==Surgery== | ||
*Approximately half of the patients with short bowel syndrome will require surgery. However, there is controversy over the efficacy of these procedures. | *Approximately half of the patients with short bowel syndrome will require [[surgery]]. However, there is controversy over the efficacy of these [[Surgery|procedures]]. | ||
*These procedures are usually performed by pediatric surgeons at a quaternary hospital who specialize in small bowel surgery. | *These [[Surgery|procedures]] are usually performed by [[Pediatrics|pediatric]] surgeons at a quaternary hospital who specialize in [[Small intestine|small bowel]] [[surgery]]. | ||
*There are two categories of surgery for | *There are two categories of [[surgery]] for short bowel syndrome including non-transplant and [[Organ transplant|transplant]] interventions.<ref name="RodriguesSeetharam2011">{{cite journal|last1=Rodrigues|first1=Gabriel|last2=Seetharam|first2=Prasad|title=Short bowel syndrome: A review of management options|journal=Saudi Journal of Gastroenterology|volume=17|issue=4|year=2011|pages=229|issn=1319-3767|doi=10.4103/1319-3767.82573}}</ref> | ||
**Non-transplant | **Non-transplant | ||
***Stricturoplasty | ***Stricturoplasty | ||
***Surgical procedures to lengthen dilated bowel | ***[[Surgery|Surgical]] procedures to lengthen dilated [[Intestine|bowel]] | ||
****Bianchi procedure: Bowel is cut in half and one end is sewn to the other | ****Bianchi [[Surgery|procedure]]: [[Intestine|Bowel]] is cut in half and one end is sewn to the other | ||
{{#ev:youtube|v=7l1f2-dF-QY}} | {{#ev:youtube|v=7l1f2-dF-QY}} | ||
:::* Serial transverse enteroplasty (STEP): Bowel is cut and stapled in a zigzag pattern | :::* Serial transverse enteroplasty (STEP): [[Intestine|Bowel]] is cut and stapled in a zigzag pattern | ||
{{#ev:youtube|v=Zjl7AjiyXwQ}} | {{#ev:youtube|v=Zjl7AjiyXwQ}} | ||
:*Transplant | :*[[Organ transplant|Transplant]] | ||
:**Isolated [[Organ transplant|intestinal transplant]] | :**Isolated [[Organ transplant|intestinal transplant]] | ||
:**Combined [[Organ transplant|intestinal and liver transplant]] | :**Combined [[Organ transplant|intestinal and liver transplant]] | ||
Revision as of 19:55, 8 December 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]
Overview
Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3].
Indications
- Surgery is not the first-line treatment option for patients with short bowel syndrome. Surgery is usually reserved for patients with either:
- Complications
- [Indication 2]
- [Indication 3]
- Transplant is not the first-line surgical option for patients with short bowel syndrome. Transplant is usually reserved for patients with either:[1]
- Life-threatening complications of intestinal failure
- Irreversible permanent total parenteral nutrition (TPN) requirement and episodes of sepsis
- Irreversible permanent total parenteral nutrition (TPN) requirement and loss of venous access
Contraindications
- Transplant is contraindicated in patients with either:[2]
- Absolute
- Active infection
- Malignancies
- Relative
- Reduced neurodevelopment
- Psychosocial factors
- Absolute
Surgery
- Approximately half of the patients with short bowel syndrome will require surgery. However, there is controversy over the efficacy of these procedures.
- These procedures are usually performed by pediatric surgeons at a quaternary hospital who specialize in small bowel surgery.
- There are two categories of surgery for short bowel syndrome including non-transplant and transplant interventions.[1]
{{#ev:youtube|v=7l1f2-dF-QY}}
- Serial transverse enteroplasty (STEP): Bowel is cut and stapled in a zigzag pattern
{{#ev:youtube|v=Zjl7AjiyXwQ}}
- Transplant
- Isolated intestinal transplant
- Combined intestinal and liver transplant
- Transplant
References
- ↑ 1.0 1.1 Rodrigues, Gabriel; Seetharam, Prasad (2011). "Short bowel syndrome: A review of management options". Saudi Journal of Gastroenterology. 17 (4): 229. doi:10.4103/1319-3767.82573. ISSN 1319-3767.
- ↑ Eça, Rosário; Barbosa, Elisabete (2016). "Short bowel syndrome: treatment options". Journal of Coloproctology. 36 (4): 262–272. doi:10.1016/j.jcol.2016.07.002. ISSN 2237-9363.