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经皮内镜下胃造口术在短肠综合征患者中的应用:香港经验。

Serial transverse enteroplasty for short bowel syndrome: Hong Kong experience.

机构信息

Division of Paediatric Surgery, Department of Surgery, Queen Elizabeth Hospital, 30 Gascoigne Road, Hong Kong.

出版信息

Hong Kong Med J. 2012 Feb;18(1):35-9.

Abstract

OBJECTIVE

To report our experience with the first series of serial transverse enteroplasty operations (a novel bowel-lengthening procedure for patients with short bowel syndrome). DESIGN. Case series.

SETTING

A tertiary paediatric surgery referral centre in Hong Kong.

PATIENTS

Four patients with short bowel syndrome aged 11 months to 14 years underwent serial transverse enteroplasty between November 2007 and June 2010.

RESULTS

A total of six such serial procedures were performed; two patients had repeated operations. Median pre-serial transverse enteroplasty small bowel length was 17.5 cm. The median increase in small bowel length was 90%. One patient experienced transient postoperative intestinal obstruction that resolved after conservative management. The median postoperative follow-up period was 31 months. The median enteral nutrition tolerance increased from 24% to 47%. The median weight-for-age z score increased by 0.55, and the median weight-for-height z score increased by 0.98. One patient had successfully weaned off parenteral nutrition.

CONCLUSION

Serial transverse enteroplasty is a feasible and safe treatment for short bowel syndrome patients, which helps to improve enteral nutrition and promote growth. Repeated serial transverse enteroplasty can be performed in patients with ultra-short bowel lengths. Follow-up is necessary to assess the long-term outcomes.

摘要

目的

报告我们在一系列连续横向肠成形术(一种用于短肠综合征患者的新型肠延长手术)中的经验。

设计

病例系列。

地点

中国香港的一家三级儿科手术转诊中心。

患者

2007 年 11 月至 2010 年 6 月期间,4 名年龄在 11 个月至 14 岁的短肠综合征患者接受了连续横向肠成形术。

结果

共进行了 6 次这样的连续手术,其中 2 名患者进行了重复手术。术前连续横向肠成形术小肠长度的中位数为 17.5cm。小肠长度的中位数增加了 90%。1 名患者出现短暂性术后肠梗阻,经保守治疗后缓解。中位术后随访时间为 31 个月。肠内营养耐受的中位数从 24%增加到 47%。体重-年龄 z 评分的中位数增加了 0.55,体重-身高 z 评分的中位数增加了 0.98。1 名患者已成功停用肠外营养。

结论

连续横向肠成形术是治疗短肠综合征患者的一种可行且安全的方法,有助于改善肠内营养和促进生长。对于超短肠长度的患者,可以重复进行连续横向肠成形术。需要进行随访以评估长期结果。

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