title: Isoperistaltic bowel lengthening for short bowel syndrome in children.
abstract: BACKGROUND
  Short bowel syndrome, secondary to a variety of causes, can be lethal in infancy and childhood. Isoperistaltic bowel lengthening, performed by longitudinal division of dilated small bowel with end-to-end anastomosis, has shown early promise but long-term outcome is unknown.
  
  
  METHODS
  Sixteen infants and children (aged 3 months to 14 years) had short bowel syndrome from necrotizing enterocolitis (8), gastroschisis (4), atresia (2), and volvulus (2). All of these patients were partially or totally dependent on parenteral nutrition and have undergone isoperistaltic bowel lengthening for short bowel syndrome (length <100 cm). Bowel length was increased by 22% to 85% (mean 42%) with the procedure. Studies of intestinal function were performed preoperatively and postoperatively.
  
  
  RESULTS
  Isoperistaltic bowel lengthening resulted in significant improvement in stool counts, intestinal transmit time, intestinal clearance of barium, D-xylose absorption, and fat absorption at 6 months and 12 months postoperatively. Fourteen of 16 patients (88%) have been weaned from parenteral nutrition.
  
  
  CONCLUSIONS
  These data show that isoperistaltic bowel lengthening can be an effective operation for short bowel syndrome in children, improving absorption and motility, and allowing weaning from parenteral nutrition.
authors.affiliation: Department of Surgery, St. Louis University Health Sciences Center and Cardinal Glennon Children's Hospital, Missouri 63104-1095, USA.
authors.forename: T R
authors.initials: TR
authors.lastname: Weber
mesh_terms: D000293:Adolescent; D000714:Anastomosis, Surgical; D002648:Child; D002675:Child, Preschool; D005769:Gastrointestinal Motility; D006801:Humans; D007223:Infant; D007408:Intestinal Absorption; D007421:Intestine, Small / Q000601:surgery*; D010288:Parenteral Nutrition; D012778:Short Bowel Syndrome / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome