Colombo P L, Sciutto A M, Ferro F, Scotti Foglieni A, Pini G, Bianchi C, Tinozzi F P, Scotti Foglieni C
Istituto di Chirurgia Generale e dei Trapianti d'Organo, Università degli Studi di Pavia.
Ann Ital Chir. 1997 Nov-Dec;68(6):823-30.
A significant problem in surgery following massive intestinal resection is the short bowel syndrome characterized by severe fluid and electrolyte loss, watery diarrhoea and malnutrition. Total parenteral nutrition and enteral nutrition are essential in the clinical course of the syndrome; their use for prolonged periods results in the gradual intestinal adaptation and greater absorptive and reservoir capacities of the intestinal remnant. Adjunctive surgery can slow rapid intestinal transit and induce growth of neo-small-bowel mucosa but is not recommended for routine use. The early results of intestinal transplantation in the treatment of short bowel syndrome are encouraging. Furthermore chronic rejection and systemic sepsis with failure of the graft must be considered and indicate that at present this procedure cannot be offered to every patient but will be a potential form of therapy in future.
大面积肠道切除术后手术中一个显著问题是短肠综合征，其特征为严重的液体和电解质丢失、水样腹泻及营养不良。全胃肠外营养和肠内营养在该综合征的临床病程中至关重要；长期使用可使肠道逐渐适应，增加残余肠道的吸收和储存能力。辅助手术可减缓肠道快速转运并促使新小肠黏膜生长，但不建议常规使用。肠道移植治疗短肠综合征的早期结果令人鼓舞。此外，必须考虑慢性排斥反应和移植物衰竭导致的全身性败血症，这表明目前该手术不能应用于每一位患者，但未来将成为一种潜在的治疗方式。
