Abstract
Objective To analyze the outcome of children with short bowel syndrome (SBS) who required long-term parenteral nutrition (PN). Study design Retrospective analysis of children (n=78) with SBS who required PN >3 months from 1975 to 2000. Statistics: univariate analysis, Kaplan-Meier method, and Cox proportional regression model were used. Results We identified 78 patients. Survival was better with small bowel length (SBL) >38 cm, intact ileocecal valve (ICV), intact colon, takedown surgery after ostomy (all P < .01), and primary anastomosis (P < .001). PN-associated early persistent cholestatic jaundice (P < .001) and SBL of <15cm (P < .01) were associated with a higher mortality. Intestinal adaptation was less likely if SBL <15 cm (P < .05), ICV was removed, colonic resection was done (both P < .001), >50% of colon was resected (P < .05), and primary anastomosis could not be accomplished (P < .01). Survival was 73% (57), and 77% (44) of survivors had intestinal adaptation. Conclusions SBL, intact ICV, intestinal continuity, and preservation of the colon are important factors for survival and adaptation. Adaptation usually occurred within the first 3 years. Need for long-term PN does not preclude achieving productive adulthood. Patients with ICV even with <15 cm of SBL and patients with SBL >15 cm without ICV have a chance of intestinal adaptation.
Original language | English (US) |
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Pages (from-to) | 157-163 |
Number of pages | 7 |
Journal | Journal of Pediatrics |
Volume | 145 |
Issue number | 2 |
DOIs | |
State | Published - Aug 2004 |
Externally published | Yes |
Keywords
- CVC
- Central venous catheter
- ESLD
- End-stage liver disease
- ICV
- Ileocecal valve
- NEC
- Necrotizing enterocolitis
- PN
- Parenteral nutrition
- SBL
- SBS
- SSB
- Short bowel syndrome
- Short small bowel
- Small bowel length
- USSB
- Ultra short small bowel
- VSSB
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health