LONG-TERM PROGNOSIS OF THE SHORT-BOWEL SY NDROME - AN ANALYSIS OF 30 CASES

To determine the influence of the underlining disease on the duration of total parenteral nutrition (TPN) and on the long-term prognosis, da ta from 30 admitted patients with permanent (n = 23) and temporary (n = 7 short bowel syndrome were retrospectively analyzed and the present status of all living patients evaluated. Patients with <<permanent sh ort bowel>> after thrombosis of the superior mesenteric artery (group I, n = 13) or malignant tumours (group II, n = 3) had a decreased surv ival compared to patients with other causes such as ileus, intestinal volvulus-thrombosis of mesenteric veins or benign tumors (group III, n = 7). Whithin the first six postoperative months, all patients in gro up I and all patients in group II died of the underlying disease where as none died in group III. One patient in group I and one patient in g roup III died as a result of complications related to TPN. The differe nt underlying diseases had no influence on the adaptation of the small intestine or on the duration of TPN in the surviving patients. Return to enteral autonomy seems to mainly depend on the length of the remai ning small and large bowel and early enteral feeding. Complications of parenteral nutrition and possible options for the surgical treatment of the shorthowell syndrome are discussed.