title: Five-year outcomes after serial transverse enteroplasty in children with short bowel syndrome.
abstract: OBJECTIVE
  The aim of this study is to report 5-year outcomes in patients who have received serial transverse enteroplasty (STEP) using clinical and biochemical assessments of intestinal function.
  
  
  METHODS
  Thirty-one STEP procedures have been performed at our institution. Twelve patients who received STEP before January 2005 were analyzed. Clinical and biochemical outcomes were performed pre-STEP and post-STEP on an annual basis. Paired t tests were used to compare post-STEP outcomes to pre-STEP values (P < .05 was significant).
  
  
  RESULTS
  There were 12 patients (3 females; median age, 5.5 months). Serial transverse enteroplasty resulted in mean increase in length of dilated bowel segment of 89% ± 26% and increase in total small bowel length of 46% ± 40%. Two patients received liver-intestinal transplants post-STEP (at 4 and 5 months), and 2 patients died of liver failure at 3 and 8 months. The remaining 8 of 12 patients all show stable intestinal absorptive capacity (data not shown). Of 8 patients, 7 were weaned off parenteral nutrition by 4 years. No patient has required repeat STEP or bowel tapering. Two patients developed staple line leak, and 1 patient developed gastrointestinal bleed from staple line ulcers.
  
  
  CONCLUSIONS
  This report represents the largest series of STEP patients followed up beyond 5 years. Long-term clinical, biochemical, and radiologic outcomes appear to be robust.
authors.affiliation: Division of General Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Carol
authors.initials: C
authors.lastname: Oliveira
authors.forename: Nicole
authors.initials: N
authors.lastname: de Silva
authors.forename: Paul W
authors.initials: PW
authors.lastname: Wales
mesh_terms: D015415:Biomarkers / Q000097:blood; D002675:Child, Preschool; D002956:Citrulline / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007408:Intestinal Absorption; D007421:Intestine, Small / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012778:Short Bowel Syndrome / Q000097:blood / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D017792:Surgical Stapling; D016896:Treatment Outcome; D014994:Xylose / Q000097:blood; D000515:alpha 1-Antitrypsin / Q000097:blood
chemical_list: D015415:Biomarkers; D000515:alpha 1-Antitrypsin; D002956:Citrulline; D014994:Xylose