Long-term results following extensive small intestinal resection in the neonatal period.

At Alder Hey Children's Hospital in Liverpool there have been 8 children who survived long-segment intestinal resection in the neonatal period for more than 10 years, and there has been one further case at the University Children's Hospital in Zürich. The total of 9 children who were left with residual lengths of small intestine of between 26 and 75 cm form the basis of this report. Seven of these children have been personally followed up. One patient, although apparently perfectly well, is now an adult, has left home and refused to be re-examined. One child has been followed up by another paediatrician. In general it can be said that, provided these children are treated with care postoperatively over a period which may extend for many months or even a few years, the ultimate prognosis is extremely good. These children will grow up perfectly normally and will have no absorption difficulties. If the child is left with less than 30 cm of small intestine, the initial treatment becomes very difficult, but with adequate management even these infants can finally grow up into perfectly normal children with little or no absorption difficulties. The critical length of intestine lies in the neighbourhood of 20 cm. Correct initial treatment is all important and the one case in this series where this was not carried out is the only child who has still considerable difficulties. In some of the children under discussion, a hemicolectomy was performed as well as the small intestinal resection. This does not seem to have made much difference to the ultimate satisfactory outcome.