[Surgical methods for adaptation of impaired absorption in cases of extensive resection of the small intestine in childhood].
Many surgical methods are available for slowing down the passage of food through the bowel to achieve better absorption in patients with extensive resections of the small intestine. Reversal of an intestinal segment seems to be the best procedure and has resulted in substantial experimental and clinical experiences. The author reviews the present state of knowledge with respect to surgical improvement of absorption. He also reports on his own experimental studies in which reversed segments of small intestine produced active slowing of passage with good mixture of chyme. For a prolonged period of time the short segments transport the chyme mixture upwards into the oral section of the bowel under low frequency, increased pressure and uniform muscle hypertrophy. To date 37 clinical cases have been published. The follow-up shows that the patients gained weight, their general condition improved and the time of passage increased. However, only five pediatric cases are reported in the world literature: of which 3 patients had a small intestine segment and two children a colon segment to achieve antiperistalsis. With one exception all children died in the postoperative phase. Death was not due to the surgical intervention. The use of an antiperistaltic segment is only indicated when the presently available means of parenteral feeding have failed or are inadequate. Segment reversal should never be used as primary treatment; segment length should not exceed 5 to 10 cm.
D000222:Adaptation, Physiological; D000367:Age Factors; D000818:Animals; D004285:Dogs; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007408:Intestinal Absorption; D007421:Intestine, Small / Q000601:surgery*; D008297:Male; D008722:Methods; D010528:Peristalsis; D051381:Rats
Operative Methoden zur Adaptation gestörter Resorption bei ausgedehnten Dünndarmresektionen im Kindesalter