J Clin Nutr.  2018 Dec;10(2):45-50. 10.15747/jcn.2018.10.2.45.

Multidisciplinary Intestinal Rehabilitation for Short Bowel Syndrome in Adults: Results in a Korean Intestinal Rehabilitation Team

• Yoon S
• Lee S
• Park HJ
• Kim HJ
• Yoon J
• Min JK
• Seo JM

• KMID: 2451729
• DOI: http://doi.org/10.15747/jcn.2018.10.2.45

Abstract

PURPOSE
Intense multidisciplinary team effort is required for the intestinal rehabilitation of patients afflicted with the short bowel syndrome (SBS). These include enteral and parenteral nutrition (PN) support, monitoring of complications related to treatment, and considering further medical or surgical options for intestinal adaptation.
METHODS
In the Intestinal Rehabilitation Team (IRT) at the Samsung Medical Center, we have experienced 20 cases of adult SBS requiring multidisciplinary intestinal rehabilitation. This study is a retrospective review of the collected medical records.
RESULTS
Of the 20 subjects treated, 12 patients were male and 8 patients were female. At the time of referral to the IRT, the mean age was 51.5 years, and the mean body weight was 50.1 kg, which was 90% of the usual body weight. The diseases or operative managements preceding massive bowel resection were malignancy in 11 cases, cardiac surgery in 2 cases, trauma in 2 cases and one case, each of tuberculosis, corrosive esophagitis, atrial fibrillation, simultaneous pancreas and kidney transplantation, and perforated appendicitis. Of these, there were 14 survivals and 6 mortalities. The fatalities were attributed to progression of disease, intestinal failure-associated liver disease, and sepsis (unrelated to intestinal failure) (2 cases each). Among the 14 surviving patients, 8 patients have been weaned off PN, whereas 6 are still dependent on PN (mean PN dependence 36%).
CONCLUSION
This paper reports the results of multidisciplinary intestinal rehabilitation of adult short bowel patients treated at the Samsung Medical Center. Further studies are required to improve survival and enteral tolerance of these patients.

Keyword

Short bowel syndrome; Intestinal rehabilitation; Parenteral nutrition; Intestinal failure-associated liver disease; Central line-associated blood stream infection

MeSH Terms

Adult*
Appendicitis
Atrial Fibrillation
Body Weight
Esophagitis
Female
Humans
Intestinal Diseases
Kidney Transplantation
Liver Diseases
Male
Medical Records
Mortality
Pancreas
Parenteral Nutrition
Referral and Consultation
Rehabilitation*
Retrospective Studies
Sepsis
Short Bowel Syndrome*
Thoracic Surgery
Tuberculosis