Mercer David F
Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Nutr Clin Pract. 2023 May;38 Suppl 1:S88-S97. doi: 10.1002/ncp.10988.
Patients with short bowel syndrome (SBS) are optimally managed in centers of expertise with dedicated multidisciplinary intestinal failure (IF) teams. Over the life of a patient with SBS, many different surgical concerns may arise requiring intervention. These can range from reasonably simple procedures, such as the creation or maintenance of gastrostomy tube and enterostomies, to complex reconstructions of multiple enterocutaneous fistulas or the performance of intestine-containing transplants. This review will cover the development of a surgeon's role on the IF team; common surgical issues arising in patients with SBS, with a focus on decision-making rather than technique; and, finally, a brief overview of transplantation and some related decision-making issues.
短肠综合征(SBS)患者在拥有专门的多学科肠道衰竭(IF)团队的专业中心接受最佳管理。在SBS患者的整个病程中,可能会出现许多不同的需要干预的外科问题。这些问题范围从相对简单的手术,如胃造瘘管和肠造口的建立或维持,到复杂的多个肠皮肤瘘重建或含肠移植手术。本综述将涵盖外科医生在IF团队中的角色发展;SBS患者中出现的常见外科问题,重点是决策而非技术;最后,简要概述移植及一些相关决策问题。