title: The first clinical application of the spiral intestinal lengthening and tailoring (silt) in extreme short bowel syndrome.
abstract: OBJECTIVE
  Spiral Intestinal Lengthening and Tailoring (SILT) invented by our team is a new technique that offers minimal mesenteric handling and a more physiological result compared to the STEP procedure. Its feasibility has been tested in animal models and now we report the first successful human application in extreme short bowel syndrome.
  
  
  METHODS
  A 3-year-old girl suffered subtotal loss of her small bowel and ileocaecal junction as a result of midgut volvulus. Only 15 cm of jejunum remained intact. Parenteral nutrition (PN), gastrostomy feeding, controlled bowel expansion and SILT procedure were applied.
  
  
  RESULTS
  The length of the jejunum increased from the initial 15 to 22 cm during 12 months of PN and bowel expansion. Eleven centimeter of distended bowel was further lengthened up to 20 cm by SILT giving a total small bowel length of 31 cm. Oral and gastrostomy feedings were commenced 5 days postoperatively. There were no surgical complications 6 months after the procedure. The patient's liver function was preserved, she was weaned off PN, discharged from hospital, but remained on gastrostomy top up feeding. The net weight gain of the patient was 1,800 g 6 months after the procedure.
  
  
  CONCLUSIONS
  SILT procedure is a safe and feasible technique for human intestinal lengthening and tailoring.
authors: Department of Pediatrics, Josa Andras Hospital Nyíregyháza, Teaching Hospital of Medical Health Science Centre University of Debrecen, Debrecen, Hungary, tcserni@yahoo.com.
authors: T
authors: T
authors: Cserni
authors: B
authors: B
authors: Biszku
authors: I
authors: I
authors: Guthy
authors: F
authors: F
authors: Dicso
authors: L
authors: L
authors: Szaloki
authors: S
authors: S
authors: Folaranmi
authors: F
authors: F
authors: Murphy
authors: G
authors: G
authors: Rakoczy
authors: A
authors: A
authors: Bianchi
authors: A
authors: A
authors: Morabito
mesh_terms: D002675:Child, Preschool; D005260:Female; D005774:Gastrostomy; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D007813:Laparotomy / Q000379:methods*; D010288:Parenteral Nutrition / Q000379:methods; D011860:Radiography, Abdominal; D012778:Short Bowel Syndrome / Q000000981:diagnostic imaging / Q000601:surgery*