The evolution of the serial transverse enteroplasty for pediatric short bowel syndrome at a single institution

Journal of Pediatric Surgery
Kevin FitzgeraldPaul W Wales

Abstract

The serial transverse enteroplasty (STEP) tapers and lengthens the gut to improve adaptation. Mortality has decreased with multidisciplinary intestinal rehabilitation programs (IRP) allowing more time to reach adaptive potential. We reviewed our STEP experience to compare surgical outcomes between early and late eras of our IRP. A retrospective cohort study of all STEP patients managed by our IRP (Jan 2003-Dec 2016; era 1 2003-2005, era 2 2006-2016) was completed. Patient demographics, operative data, complications, and outcome data were collected. Univariate analysis between eras with nonparametric statistics was performed. Thirty-six patients received STEP (Era 1 = 12; Era 2 = 24) [median age 5mo; males 22/36 (61.1%)]. In Era 2 a higher proportion had gastroschisis (8.3% vs 58.3%); p = 0.004) and shorter pre-STEP small bowel remnant (48 vs 111 cm, p = 0.001). The median increase in bowel length post-STEP was 52.9%. Overall, 42% of patients reached enteral autonomy (Era 1 7/12 (58%) vs Era 2 8/24 (33%); p = 0.15). Median time to PN discontinuation was shorter in Era 1 (259 vs 968 days, p = .208). Staple line complications were higher in Era 1 (16.7% vs 0%; p = 0.040). Presently, STEP is reserved for a specific subset of IRP pa...Continue Reading

Citations

Oct 27, 2020·Pediatric Surgery International·Albert ShunCatherine Langusch
Nov 17, 2020·European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [et Al] = Zeitschrift Für Kinderchirurgie·Anne DarielMarie-Edith Coste
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 17, 2020·Journal of Paediatrics and Child Health·Jason Y K YapJulie E Bines

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