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在一例短肠综合征患者中,同时采用 Bianchi 手术和空肠造口关闭术提高生活质量。

Improvement in the quality of life using both Bianchi's procedure and the closure of a jejunostomy in a case with short bowel syndrome.

作者信息

Masumoto Kouji, Souzaki Ryouta, Nagata Kouji, Uesugi Toru, Nishimoto Yuko, Taguchi Tomoaki

机构信息

Department of Pediatric Surgery, Reproductive and Developmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.

出版信息

Pediatr Surg Int. 2007 Mar;23(3):285-8. doi: 10.1007/s00383-006-1797-2. Epub 2006 Sep 22.

DOI:10.1007/s00383-006-1797-2
PMID:17021735
Abstract

In cases with short bowel syndrome (SBS), intestinal adaptation often requires a long time. In addition, the quality of life in SBS is not especially good due to some complications, including growth impairment, severe diarrhea, complications of parenteral nutrition (PN), and so on. We herein report an adolescent boy with SBS secondary to midgut volvulus. He suffered mainly from both severe high output syndrome, which caused a large amount of enteric fluid to flow out from the jejunostomy, and growth impairment, although PN continued after the occurrence of SBS. As a result, he thereafter could not continue his daily school life. Therefore, he was introduced to our department at 6 months after the operation. A closure of the jejunostomy combined with longitudinal intestinal lengthening using Bianchi's procedure was performed. Thereafter, the above-described symptoms disappeared. He was discharged and thereafter was again able to attend school with an improvement in his growth within 2 months after the second operation. Home PN was discontinued at 15 months after the second operation. Based on our experience, in cases of SBS without intestinal functional disorder, an early closure of the jejunostomy combined with Bianchi's procedure might therefore possibly lead to an early improvement in the complications related to SBS.

摘要

在短肠综合征(SBS)病例中,肠道适应通常需要很长时间。此外,由于一些并发症,包括生长发育障碍、严重腹泻、肠外营养(PN)并发症等,SBS患者的生活质量并不特别好。我们在此报告一名因中肠扭转继发SBS的青少年男性。尽管在发生SBS后继续进行了PN治疗,但他主要遭受严重的高输出综合征,导致大量肠液从空肠造口流出,以及生长发育障碍。结果,他此后无法继续日常的学校生活。因此,术后6个月他被转诊至我们科室。进行了空肠造口关闭术并结合使用比安奇手术进行纵向肠道延长术。此后,上述症状消失。他出院了,并且在第二次手术后2个月内再次能够上学,生长情况有所改善。第二次手术后15个月停止了家庭PN治疗。基于我们的经验,对于无肠道功能障碍的SBS病例,早期进行空肠造口关闭术并结合比安奇手术可能会使与SBS相关的并发症早日得到改善。

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引用本文的文献

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Intestinal bowel lengthening in children with short bowel syndrome: systematic review of the Bianchi and STEP procedures.儿童短肠综合征的肠延长术:Bianchi 和 STEP 手术的系统评价。
World J Surg. 2013 Mar;37(3):694-704. doi: 10.1007/s00268-012-1879-3.

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