Short bowel mucosal morphology, proliferation and inflammation at first and repeat STEP procedures

Journal of Pediatric Surgery
Annika MutanenMikko P Pakarinen

Abstract

Although serial transverse enteroplasty (STEP) improves function of dilated short bowel, a significant proportion of patients require repeat surgery. To address underlying reasons for unsuccessful STEP, we compared small intestinal mucosal characteristics between initial and repeat STEP procedures in children with short bowel syndrome (SBS). Fifteen SBS children, who underwent 13 first and 7 repeat STEP procedures with full thickness small bowel samples at median age 1.5 years (IQR 0.7-3.7) were included. The specimens were analyzed histologically for mucosal morphology, inflammation and muscular thickness. Mucosal proliferation and apoptosis was analyzed with MIB1 and Tunel immunohistochemistry. Median small bowel length increased 42% by initial STEP and 13% by repeat STEP (p=0.05), while enteral caloric intake increased from 6% to 36% (p=0.07) during 14 (12-42) months between the procedures. Abnormal mucosal inflammation was frequently observed both at initial (69%) and additional STEP (86%, p=0.52) surgery. Villus height, crypt depth, enterocyte proliferation and apoptosis as well as muscular thickness were comparable at first and repeat STEP (p>0.05 for all). Patients, who required repeat STEP tended to be younger (p=0.057)...Continue Reading

Citations

Jul 25, 2019·Pediatric Gastroenterology, Hepatology & Nutrition·Olivier GouletCécile Lambe
Oct 27, 2020·Pediatric Surgery International·Albert ShunCatherine Langusch
Mar 5, 2021·European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [et Al] = Zeitschrift Für Kinderchirurgie·Sjoerd C J NagelkerkeR Bakx
Nov 3, 2020·Journal of Pediatric Surgery·Galina SanaksenahoMikko P Pakarinen
Oct 5, 2021·Genome Génome / Conseil National De Recherches Canada·Ayse Gokce KeskusOzlen Konu

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