Isoperistaltic bowel lengthening for short bowel syndrome in children

BACKGROUND: Short bowel syndrome, secondary to a variety of causes, can be lethal in infancy and childhood. Isoperistaltic bowel lengthening, performe d by longitudinal division of dilated small bowel with end-to-end anastomos is, has shown early promise but long-term outcome is unknown. METHODS: Sixteen infants and children (aged 3 months to 14 years) had short bowel syndrome from necrotizing enterocolitis (8), gastroschisis (4), atre sia (2), and volvulus (2), All of these patients were partially or totally dependent on parenteral nutrition and have undergone isoperistaltic bowel l engthening for short bowel syndrome (length <100 cm), Bowel length was incr eased by 22% to 85% (mean 42%) with the procedure. Studies of intestinal fu nction were performed preoperatively and postoperatively, RESULTS: Isoperistaltic bowel lengthening resulted in significant improveme nt in stool counts, intestinal transmit time, intestinal clearance of bariu m, D-xylose absorption, and fat absorption at 6 months and 12 months postop eratively. Fourteen of 16 patients (88%) have been weaned from parenteral n utrition. CONCLUSIONS: These data show that isoperistaltic bowel lengthening can be a n effective operation for short bowel syndrome in children, improving absor ption and motility, and allowing weaning from parenteral nutrition. Am J Su rg. 1999;178: 600-604, (C) 1999 by Excerpta Medica, Inc.