title: Prospective evaluation of the absorptive capacity of the bowel after major and minor resections in the neonate.
abstract: The outcome after major bowel resection in the neonatal period depends primarily on the time needed for bowel adaptation. A prospective study was begun in neonates after small bowel resection to evaluate the absorptive capacity of the bowel and growth parameters as a result of adaptation of the bowel. Twenty-four neonates who underwent bowel resection were included. The underlying diagnoses were necrotising enterocolitis (12), jejunal atresia (3), meconium peritonitis (3), and other (6). During the study, a standardized treatment with respect to nutrition was followed. At predetermined times, enterostomy fluid or faeces were collected for analysis of carbohydrate content, fat content, and fatty acids, together with a xylose test and a hydrogen breath test. Growth parameters included weight and height. The 24 patients were divided into two groups. Group A consisted of eight patients with short bowel syndrome (defined as loss of more than 50% of the original small bowel length related to gestational age). The mean remaining small bowel length in this group was 34.0% (24% to 42%). Group B consisted of 16 patients who had only minor bowel resections. Retarded growth was observed in four group A patients. Low levels of carbohydrate absorption were found 2 and 4 weeks after the initial operation in group A, and 2 weeks after the initial operation in group B. Low levels of fat absorption were found 4 and 8 weeks after the initial operation in group A. The coefficient of absorption of the different fatty acids showed complete absorption of caprylic acid.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Paediatric Surgery, Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: G
authors.initials: G
authors.lastname: Liefaard
authors.forename: E
authors.initials: E
authors.lastname: Heineman
authors.forename: J C
authors.initials: JC
authors.lastname: Molenaar
authors.forename: D
authors.initials: D
authors.lastname: Tibboel
mesh_terms: D016022:Case-Control Studies; D004761:Enterocolitis, Pseudomembranous / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006130:Growth Disorders / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D007408:Intestinal Absorption / Q000502:physiology*; D007409:Intestinal Atresia / Q000503:physiopathology / Q000601:surgery*; D007583:Jejunum / Q000002:abnormalities*; D008297:Male; D011446:Prospective Studies; D012778:Short Bowel Syndrome / Q000503:physiopathology*; D016896:Treatment Outcome