Redilation of bowel after intestinal lengthening procedures--an indicator for poor outcome.
OBJECTIVE
Despite a good understanding of short-term outcomes of the longitudinal intestinal lengthening and tailoring (LILT) and serial transverse enteroplasty (STEP) procedures, limited data exist on long-term complications.


METHODS
This is a 15-year single-institution retrospective chart review of patients who underwent an intestinal lengthening procedure (ILP). Long-term ILP-related complications, their interval to development, patients' ability to wean off parenteral nutrition (PN), and the need for further procedures were analyzed.


RESULTS
Of 119 patients with short bowel syndrome, 14 had undergone an ILP. Seven patients had an LILT, and 9 patients had a STEP, including repeat ILPs on the same patient. Overall, 93% of patients had complications. Four patients in the LILT group and 3 patients in the STEP group weaned off PN. Eight patients (57%) experienced bowel redilation after their ILP. The 2 deaths in the study came from this group. Seven required another abdominal operation and only one weaned off PN. There were no significant differences in mean bowel length between the redilated group and the non-re-dilated group.


CONCLUSIONS
Complications are common after ILPs, and patients who redilated their bowel after ILP did clinically worse than those who did not.
Department of Surgery, Section of Pediatric Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
Eiichi A
EA
Miyasaka
Pamela I
PI
Brown
Daniel H
DH
Teitelbaum
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004108:Dilatation, Pathologic / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007410:Intestinal Diseases / Q000209:etiology* / Q000601:surgery; D007421:Intestine, Small / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D010288:Parenteral Nutrition; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012778:Short Bowel Syndrome / Q000601:surgery*; D016896:Treatment Outcome