Surgical Approach to Complicated Intestinal Failure for Benign Disease in Adult Patients: Transplantation or Surgical Rehabilitation?

A. Lauro, C. Zanfi, A. Dazzi, L. Golfieri, A. Amaduzzi, G. Ercolani, M. Cescon, A. Siniscalchi, G. L. Grazi, M. Vivarelli, G. Varotti, M. Ravaioli, M. Del Gaudio, F. Di Benedetto, A. Cucchetti, G. La Barba, G. Vetrone, M. Zanello, L. Pironi, S. FaenzaA. D. Pinna

Research output: Contribution to journalArticlepeer-review

Abstract

Surgical approaches to complicated benign intestinal failure are gaining acceptance, especially in the pediatric population. Less international experience has been obtained in adult patients, who are usually treated with total parenteral nutrition (TPN). An intestinal rehabilitation program was started in our institution with comprehensive medical rehabilitation, surgical bowel rescue, and transplantation. Among 38 adult patients referred by our gastroenterologists for bowel rehabilitation and surgically treated in our institution, 92.2% received TPN on admission. After careful evaluation, 71% underwent transplantation. Five patients died, but 18 recipients were completely weaned off TPN at follow-up. Eleven patients underwent surgical resection of the affected bowel and a subsequent program of intestinal rehabilitation: they were all alive and weaned off TPN at discharge. At a 2-year mean follow-up, deaths occurred only in the transplant population. Therefore, intestinal surgical rescue, if successful, is optimal in adult patients.

Original languageEnglish
Pages (from-to)1145-1147
Number of pages3
JournalTransplantation Proceedings
Volume38
Issue number4
DOIs
Publication statusPublished - May 2006

ASJC Scopus subject areas

  • Surgery
  • Transplantation

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