Adv Pediatr Surg.  2023 Jun;29(1):24-31. 10.13029/aps.2023.29.1.24.

Intestinal Length Growth Differences Among Diseases Underlying Pediatric Short Bowel Syndrome

• Cho YJ
• Kwon H
• Kwon YJ
• Kim SC
• Kim DY
• Namgoong JM

• KMID: 2551509
• DOI: http://doi.org/10.13029/aps.2023.29.1.24

Abstract

Purpose
Increases in intestinal length (IL) in patients with short bowel syndrome (SBS) may differ by age and underlying diseases. This study analyzed the elongation rate of the remnant IL according to underlying disease to establish a therapeutic plan for intestinal rehabilitation.
Methods
The charts of SBS patients who underwent surgery at our center from 2000 to 2018 were retrospectively reviewed. The enrolled patients included those with a remaining IL less than 25% of the average and those with a remaining IL of approximately 50% who had been administered parenteral nutrition for more than one year. Patients were excluded if they underwent only one operation or two operations with the first being a serial transverse enteroplasty procedure, meaning that base length was not known.
Results
Ten patients were enrolled. Causes of SBS included total colonic aganglionosis (TCA) in seven patients (70.0%), necrotizing enteritis in two (20.0%), and malrotation/volvulus in one (10.0%). The IL growth rate in the three non-TCA patients was 9-fold higher than the estimated proportion, whereas the growth rate of the IL according to age was significantly lower in the TCA than in the non-TCA group (p=0.01).
Conclusion
The IL growth rate may differ between TCA and non-TCA patients in SBS. Rehabilitation protocols might consider the underlying disease. Additional larger trials are required to confirm these findings.

Keyword

Short bowel syndrome; Total colonic aganglionosis; Pediatrics