[Multiple colonic anastomoses in the surgical treatment of short bowel syndrome. A new technique].
BACKGROUND
Some surgical pathologies eventually require intestinal resection. This may lead to an extended procedure such as leaving 30 cm of proximal jejunum and left and sigmoid colon. One of the most important consequences of this type of resection is "intestinal failure" or short bowel syndrome. This complex syndrome leads to different metabolic and water and acid/base imbalances, as well as nutritional and immunological challenges along with the problem accompanying an abdomen subjected to many surgical procedures and high mortality. Many surgical techniques have been developed to improve quality of life of patients.


METHODS
We designed a non-transplant surgical approach and performed the procedure on two patients with postoperative short bowel syndrome with <40 cm of proximal jejunum and left colon.


RESULTS
There are a variety of non-transplant surgical procedures that, due to their complex technique or high mortality rate, have not resolved this important problem. However, the technique we present in this work can be performed by a large number of surgeons. The procedure has a low morbimortality rate and offers the opportunity for better control of metabolic and acid/base balance, intestinal transit and proper nutrition.


CONCLUSIONS
We consider that this technique offers a new alternative for the complex management required by patients with short bowel syndrome and facilitates their long-term nutritional control.
Robledo-Ogazón
Felipe
F
División de Cirugía, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico, D.F., Mexico. faro@att.net.mx
Becerril-Martínez
Guillermo
G
Hernández-Saldaña
Víctor
V
Zavala-Aznar
Marí Luisa
ML
Bojalil-Durán
Luis
L
D000714:Anastomosis, Surgical / Q000379:methods; D003106:Colon / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D006801:Humans; D007583:Jejunum / Q000473:pathology / Q000601:surgery*; D010289:Parenteral Nutrition, Total; D012778:Short Bowel Syndrome / Q000601:surgery* / Q000628:therapy