To Wean or Not to Wean: The Role of Autologous Reconstructive Surgery in the Natural History of Pediatric Short Bowel Syndrome on Behalf of Italian Society for Gastroenterology, Hepatology and Nutrition (SIGENP)

Teresa Capriati, Antonella Mosca, Tommaso Alterio, Maria Immacolata Spagnuolo, Paolo Gandullia, Antonella Lezo, Paolo Lionetti, Lorenzo D'Antiga, Fabio Fusaro, Antonella Diamanti

Research output: Contribution to journalReview articlepeer-review

Abstract

Pediatric Short Bowel Syndrome (SBS) can require prolonged parenteral nutrition (PN). Over the years, SBS management has been implemented by autologous gastrointestinal reconstructive surgery (AGIR). The primary objective of the present review was to assess the effect of AGIR on weaning off PN. We also evaluated how AGIR impacts survival, the need for transplantation (Tx) and the development of liver disease (LD). We conducted a systematic literature search to identify studies published from January 1999 to the present and 947 patients were identified. PN alone was weakly associated with higher probability of weaning from PN (OR = 1.1, p = 0.03) and of surviving (OR = 1.05, p = 0.01). Adjusting for age, the probability of weaning off PN but of not surviving remained significantly associated with PN alone (OR = 1.08, p = 0.03). Finally, adjusting for age and primary diagnosis (gastroschisis), any association was lost. The prevalence of TX and LD did not differ by groups. In conclusion, in view of the low benefit in terms of intestinal adaptation and of the not negligible rate of complications (20%), a careful selection of candidates for AGIR should be required. Bowel dilation associated with failure of advancing EN and poor growth, should be criteria to refer for AGIR.

Original languageEnglish
JournalNutrients
Volume12
Issue number7
DOIs
Publication statusPublished - Jul 18 2020

Keywords

  • Child
  • Digestive System Surgical Procedures/methods
  • Female
  • Gastroenterology/organization & administration
  • Humans
  • Italy/epidemiology
  • Liver Diseases/epidemiology
  • Male
  • Nutritional Sciences/organization & administration
  • Parenteral Nutrition
  • Patient Selection
  • Prevalence
  • Reconstructive Surgical Procedures/methods
  • Short Bowel Syndrome/mortality
  • Societies, Medical/organization & administration
  • Societies, Scientific/organization & administration
  • Survival
  • Transplantation, Autologous/statistics & numerical data

Fingerprint Dive into the research topics of 'To Wean or Not to Wean: The Role of Autologous Reconstructive Surgery in the Natural History of Pediatric Short Bowel Syndrome on Behalf of Italian Society for Gastroenterology, Hepatology and Nutrition (SIGENP)'. Together they form a unique fingerprint.

Cite this