Lessons learned from successful autologous gastrointestinal reconstruction in patients with intestinal failure: a case series

BMC Surgery

Kiarash Ashrafzadeh¹  Nazanin Azadeh¹  Maryam Esmaeili¹  Hamed Nikoupour¹  Mojtaba Shafiekhani² 

[1] Shiraz Organ Transplant Center, Abu-Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran;Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran;

关键词: Autologous gastrointestinal reconstruction;    Enterocutaneous fistula;    Intestinal failure;    Intestinal rehabilitation unit;   

DOI  :  10.1186/s12893-021-01075-9

来源: Springer

【 摘 要 】

BackgroundIntestinal failure (IF) is a rare but severe form of organ failure. The condition is defined as body’s inability to absorb adequate fluids, macronutrients and minerals for growth and development, so that intravenous supplementation is necessary. A broad spectrum of diseases, trauma and complications of surgery might eventually end up with intestinal failure. Nowadays, intestinal failure patients are preferably cared for in intestinal rehabilitation units (IRU). Autologous gastrointestinal reconstruction (AGIR) refers to non-transplant operative management of IF patients designed to improve enteral tolerance and gut absorptive capacity.Case presentationHerein we present five cases with complications of surgeries due to peptic ulcer bleeding, blunt abdominal trauma, obesity and gastric tumor. The surgeries were complicated by anastomotic leak, peritonitis and fistula formation. By adopting multidisciplinary decisions and special care for each complication, all the five patients were successfully managed and discharged.Discussion and conclusionsAs presented, re-anastomosis in presence of abdominal contamination will probably fail. In patients with intestinal failure, PN should start as soon as possible to increase the success rate of future surgeries and prevent potential need for intestinal transplantation. We suggest referring patients with complicated outcomes of gastrointestinal surgeries to the IRUs to reduce morbidity and mortality.

【 授权许可】

CC BY