Department of Surgery, Section of Pediatric Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
J Pediatr Surg. 2011 Jan;46(1):145-9. doi: 10.1016/j.jpedsurg.2010.09.084.
BACKGROUND/PURPOSE: Despite a good understanding of short-term outcomes of the longitudinal intestinal lengthening and tailoring (LILT) and serial transverse enteroplasty (STEP) procedures, limited data exist on long-term complications.
This is a 15-year single-institution retrospective chart review of patients who underwent an intestinal lengthening procedure (ILP). Long-term ILP-related complications, their interval to development, patients' ability to wean off parenteral nutrition (PN), and the need for further procedures were analyzed.
Of 119 patients with short bowel syndrome, 14 had undergone an ILP. Seven patients had an LILT, and 9 patients had a STEP, including repeat ILPs on the same patient. Overall, 93% of patients had complications. Four patients in the LILT group and 3 patients in the STEP group weaned off PN. Eight patients (57%) experienced bowel redilation after their ILP. The 2 deaths in the study came from this group. Seven required another abdominal operation and only one weaned off PN. There were no significant differences in mean bowel length between the redilated group and the non-re-dilated group.
Complications are common after ILPs, and patients who redilated their bowel after ILP did clinically worse than those who did not.
背景/目的：尽管人们对纵向肠延长和裁剪（LILT）和连续横向肠成形术（STEP）手术的短期结果有很好的了解，但关于长期并发症的数据有限。
这是一项为期 15 年的单机构回顾性图表研究，研究对象为接受肠延长手术（ILP）的患者。分析了长期 ILP 相关并发症的发生时间、患者停止肠外营养（PN）的能力以及是否需要进一步手术等情况。
在 119 例短肠综合征患者中，有 14 例接受了 ILP。7 例患者行 LILT，9 例患者行 STEP，其中同一患者行重复 ILP。总体而言，93%的患者出现并发症。LILT 组有 4 例患者和 STEP 组有 3 例患者停止使用 PN。8 例（57%）患者在 ILP 后出现肠扩张。研究中的 2 例死亡均来自该组。7 例需要再次进行腹部手术，只有 1 例停止使用 PN。扩张组和非扩张组的平均肠段长度无显著差异。
ILP 后并发症很常见，且肠扩张的患者临床状况比未扩张的患者差。
