Heeckt P F, Klein D, Beger H G
Chirurgische Klinik I, Universität Ulm.
Langenbecks Arch Chir Suppl Kongressbd. 1996;113:389-93.
After massive intestinal resection resulting in short bowel syndrome it is often unclear if the patient will remain on total parenteral nutrition (TPN) or regain enteral autonomy. Small bowel transplantation or bowel-lengthening procedures could potentially be a therapeutic option for patients confined to life-long parenteral nutrition. Initiated early in the course of the disease this could prevent frequent serious complications of long-term parenteral nutrition. However, it is unclear which factors determine the outcome of these patients. For further information on the long-term prognosis, data of 33 patients with short bowel syndrome operated in our institution from 1982 to 1995 were retrospectively analyzed and the present status of all living patients evaluated. Gender, age or underlying disease had no influence on the adaptation of the small intestine or the duration of TPN in the surviving patients. Return to enteral autonomy mainly depended upon the length of the remaining small and large bowel. Thus the further course of the disease can be predicted and necessary measures can be taken as this information is always available at the time of initial surgery.
在因广泛肠道切除导致短肠综合征后，患者是否会一直依赖全胃肠外营养（TPN）或恢复肠道自主功能往往并不明确。小肠移植或肠道延长手术可能是那些终身依赖胃肠外营养患者的一种治疗选择。在疾病早期开展此类手术可预防长期胃肠外营养引发的频繁严重并发症。然而，尚不清楚哪些因素决定这些患者的预后。为获取更多关于长期预后的信息，我们对1982年至1995年在我院接受手术的33例短肠综合征患者的数据进行了回顾性分析，并评估了所有在世患者的当前状况。性别、年龄或基础疾病对存活患者小肠的适应性或TPN持续时间并无影响。恢复肠道自主功能主要取决于剩余小肠和大肠的长度。因此，鉴于在初次手术时总能获取此类信息，疾病的后续进程便可得到预测，且可采取必要措施。
