title: Surgical management and autologous intestinal reconstruction in short bowel syndrome.
abstract: Short bowel syndrome (SBS) is a serious condition with considerable morbidity and mortality. When treatment with parenteral nutrition fails and life-threatening complications occur, autologous intestinal reconstruction (AIR) should be considered before intestinal transplantation (ITx). Single or combined ITx should be reserved for patients with severe liver disease and as last resort in the treatment of SBS. Longitudinal intestinal lengthening and tailoring (LILT) has proven its value in AIR, but its availability depends on the expertise of the surgeons. Serial transverse enteroplasty (STEP) has similar success rates as LILT and fewer patients progress to ITx. STEP is also applicable at small bowel dilatation in ultra-short bowel syndrome. The scope may be widened when duodenal dilatation can be treated as well. Spiral intestinal lengthening and tailoring (SILT) is a promising alternative. More research is needed to confirm these findings. Therefore we suggest an international data registry for all intestinal lengthening procedures.
authors.affiliation: Department of Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands. Electronic address: m.j.p.hommel@gmail.com.
authors.forename: Matthijs J
authors.initials: MJ
authors.lastname: Hommel
authors.affiliation: Department of Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands. Electronic address: r.van.baren@umcg.nl.
authors.forename: Robertine
authors.initials: R
authors.lastname: van Baren
authors.affiliation: Department of Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands. Electronic address: j.w.haveman@umcg.nl.
authors.forename: Jan Willem
authors.initials: JW
authors.lastname: Haveman
mesh_terms: D013505:Digestive System Surgical Procedures / Q000379:methods*; D006801:Humans; D010288:Parenteral Nutrition; D012778:Short Bowel Syndrome / Q000601:surgery*
keywords: Bariatric surgery; Intestinal failure; Longitudinal intestinal lengthening and tailoring; Serial transverse enteroplasty; Short bowel syndrome; Spiral intestinal lengthening and tailoring