a Emergency Surgery Department , St. Orsola University Hospital , Bologna , Italy.
b Gastroenterology Hepatology Nutrition Unit , Hôpital Necker-Enfants Malades , Paris , France.
Expert Rev Gastroenterol Hepatol. 2019 Jan;13(1):55-70. doi: 10.1080/17474124.2019.1541736. Epub 2018 Oct 31.
Short bowel syndrome (SBS) is a dramatic clinical condition in both children and adults; the residual bowel length is not sufficient to avoid intestinal failure, with subsequent malnutrition and growth retardation, and intravenous support is required to provide the nutrients normally coming from the intestine. Apart from the primary disease, the medical status can be worsened by complications of intestinal failure: if there are irreversible, the prognosis is poor unless a successful intestinal rehabilitation is achieved. Areas covered: The rescue of the remnant small bowel requires a multidisciplinary expertise to achieve digestive autonomy. The use of intestinal trophic factors has shown encouraging results in improving the intestinal adaptation process. Whenever the residual bowel length is inadequate, in a well-selected population weaning parenteral nutrition (PN) off could be attempted by surgery through lengthening procedures. A further subset of patients, with total and irreversible intestinal failure and severe complications on PN, may have an indication to intestinal transplantation. This procedure is still affected by poor long-term results. Expert commentary: Novel approaches developed through a multidisciplinary team work, such as manipulation of microbiota or tissue bioengineering, should be added to current therapies to treat successfully SBS.
短肠综合征（SBS）是儿童和成人的一种严重临床病症；残留的肠段不足以避免肠道衰竭，随后会出现营养不良和生长迟缓，需要静脉支持来提供通常来自肠道的营养。除了原发性疾病外，肠道衰竭的并发症还会使患者的身体状况恶化：如果这些并发症是不可逆转的，那么除非成功进行肠道康复，否则预后不佳。 涵盖领域： 为实现消化自主，需要多学科专业知识来抢救残留的小肠。肠营养因子的使用已显示出在改善肠道适应过程方面令人鼓舞的结果。只要残留的肠段不足，在选择良好的人群中，可以通过手术进行延长来尝试停止肠外营养（PN）。对于总肠和不可逆肠衰竭以及 PN 严重并发症的另一组患者，可能需要进行肠移植。该手术仍然受到长期效果不佳的影响。 专家评论： 应该将通过多学科团队工作开发的新方法，例如操纵微生物群或组织生物工程，添加到目前的治疗中，以成功治疗 SBS。
