Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
Dig Dis Sci. 2024 May;69(5):1770-1777. doi: 10.1007/s10620-024-08285-0. Epub 2024 Mar 6.
BACKGROUND & AIMS: The intestinal rehabilitation program (IRP) is a specialized approach to managing patients with intestinal failure (IF). The goal of IRP is to reduce the patient's dependence on parenteral nutrition by optimizing nutrition intake while minimizing the risk of complications and providing individualized medical and surgical treatment. We aimed to provide a thorough overview of our extensive history in adult IRP.
We reviewed the medical records of adults with IF treated at our center's IRP over the past two decades. We collected data on demographic and clinical results, such as the causes of IF, the current status of the remaining bowel, nutritional support, and complications or mortality related to IF or prolonged parenteral nutrition.
We analyzed a total of 47 adult patients with a median follow-up of 6.7 years. The most common cause of IF was massive bowel resection due to mesenteric vessel thrombosis (38.3%). Twenty-eight patients underwent rehabilitative surgery, including 12 intestinal transplants. The 5-year survival rate was 81.9% with 13 patients who expired due to sepsis, liver failure, or complication after transplantation. Of the remaining 34 patients, 18 were successfully weaned off from parenteral nutrition.
Our results of IRP over two decades suggest that the individualized and multidisciplinary program for adult IF is a promising approach for improving patient outcomes and achieving nutritional autonomy.
肠康复计划（IRP）是一种专门用于管理肠衰竭（IF）患者的方法。IRP 的目标是通过优化营养摄入，同时将并发症的风险降到最低，并提供个体化的医疗和手术治疗，减少患者对肠外营养的依赖。我们旨在全面回顾我们在成人 IRP 方面的丰富历史。
我们回顾了过去二十年在我们中心的 IRP 接受治疗的成人 IF 患者的病历。我们收集了人口统计学和临床结果的数据，例如 IF 的病因、剩余肠道的现状、营养支持以及与 IF 或长期肠外营养相关的并发症或死亡率。
我们共分析了 47 名成年患者，中位随访时间为 6.7 年。IF 的最常见原因是肠系膜血管血栓形成导致的大量肠切除术（38.3%）。28 名患者接受了康复手术，包括 12 例肠移植。5 年生存率为 81.9%，有 13 名患者因脓毒症、肝功能衰竭或移植后并发症而死亡。在其余 34 名患者中，有 18 名成功地脱离了肠外营养。
我们在过去二十年中进行 IRP 的结果表明，针对成人 IF 的个体化和多学科计划是改善患者预后和实现营养自主的有前途的方法。
