Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
Department of Pharmaceutical Services, Emory University Hospital, Atlanta, Georgia, USA.
JPEN J Parenter Enteral Nutr. 2024 Nov;48(8):965-973. doi: 10.1002/jpen.2682. Epub 2024 Sep 2.
Serial transverse enteroplasty is used to treat patients with chronic intestinal failure owing to short bowel syndrome. Current literature lacks discussion of its role for other etiologies of intestinal failure and its impact on adult patients' nutrition support needs and quality of life.
We performed a case series on adults with parenteral nutrition (PN) dependence who underwent serial transverse enteroplasty at Emory University Hospital, a quaternary referral center between 2011 and 2022. Data collected included demographics, operative technique, and preoperative and postoperative PN requirements. A phone survey was administered to evaluate the impact of PN and the operation on quality of life.
Ten patients underwent the procedure of interest during the study period. Indications included short bowel syndrome following multiple abdominal operations or intra-abdominal catastrophe and chronic partial bowel obstruction with dysmotility. Bowel length increased by a median of 83%. All patients were discharged home after a median hospital stay of 21 days. At 1-year follow-up, survival was 100%, two (20%) patients fully weaned from PN, three others (30%) reduced PN frequency, and six (60%) decreased their daily parenteral energy requirement. Two additional patients fully weaned from PN by 18 months postoperatively.
This represents one of the largest case series of serial transverse enteroplasty in adults. Small intestinal length nearly doubled, and PN dependence was reduced in most patients. Given the low morbidity and good quality of life observed in this series, this procedure should be more widely investigated for patients with chronic intestinal failure.
连续横向肠成形术用于治疗因短肠综合征导致的慢性肠衰竭患者。目前的文献缺乏对其在其他类型肠衰竭中的作用的讨论，以及对成年患者营养支持需求和生活质量的影响。
我们对 2011 年至 2022 年期间在埃默里大学医院接受连续横向肠成形术的依赖肠外营养（PN）的成年患者进行了病例系列研究。收集的数据包括人口统计学、手术技术以及术前和术后 PN 需求。通过电话调查评估 PN 和手术对生活质量的影响。
在研究期间，有 10 名患者接受了该手术。适应证包括多次腹部手术或腹腔内灾难后发生的短肠综合征和慢性部分肠梗阻伴动力障碍。肠长度中位数增加了 83%。所有患者在中位住院 21 天后出院回家。在 1 年的随访中，生存率为 100%，2 名（20%）患者完全脱离 PN，另外 3 名（30%）减少 PN 频率，6 名（60%）减少每日肠外能量需求。另外 2 名患者在术后 18 个月完全脱离 PN。
这是成人连续横向肠成形术最大的病例系列之一。小肠长度几乎增加了一倍，大多数患者对 PN 的依赖减少。鉴于本系列观察到的低发病率和良好的生活质量，该手术应更广泛地用于慢性肠衰竭患者。
