Surgical options to enhance intestinal function in patients with short bowel syndrome.
OBJECTIVE
This review will provide the practitioner with an understanding of the spectrum of nontransplant surgical options for managing patients with short bowel syndrome (SBS).


RESULTS
Intestinal lengthening procedures are a promising therapy to allow autonomy from parenteral nutrition. The recently described serial transverse enteroplasty is an effective procedure that is easier to perform and has similar outcomes to the more standard longitudinal lengthening procedure described by Bianchi.


CONCLUSIONS
There are several surgical options for management of the SBS, including construction of intestinal valves or reversed intestinal segments, interposition of segments of colon, or intestinal lengthening procedures. The choice of technique is dictated by the patient's underlying pathophysiology and includes such factors as intestinal transit time, length of remnant bowel, presence of intact colon, and degree of small bowel dilation. Nontransplant surgical interventions are important adjuncts to the elimination of parenteral nutrition dependence and need for intestinal transplantation.
Division of Pediatric Surgery, Department of Surgery, St Louis Children's Hospital, Washington University School of Medicine, St Louis, Missouri, USA.
Josh
J
Sommovilla
Brad W
BW
Warner
D002648:Child; D002675:Child, Preschool; D013505:Digestive System Surgical Procedures / Q000379:methods; D005772:Gastrointestinal Transit; D006801:Humans; D007421:Intestine, Small / Q000503:physiopathology / Q000601:surgery*; D010288:Parenteral Nutrition / Q000706:statistics & numerical data*; D011300:Preoperative Care / Q000379:methods*; D011788:Quality of Life; D020127:Recovery of Function; D012778:Short Bowel Syndrome / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome