Prospective evaluation of the absorptive capacity of the bowel after major and minor resections in the neonate.
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)
Liefaard
G
G
Department of Paediatric Surgery, Sophia Children's Hospital, Rotterdam, The Netherlands.
Heineman
E
E
Molenaar
J C
JC
Tibboel
D
D
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