Multidisciplinary intestinal rehabilitation in acute type II intestinal failure: Results from an intestinal rehabilitation team

Asian Journal of Surgery

Ja-Kyung Min¹  Sanghoon Lee²  Hyun-Jung Kim²  Hyo Jung Park³  Jeong-Meen Seo³  Soo-Min Jung³ 

[1] Corresponding author. Intestinal Rehabilitation Team, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.;Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, South Korea;Intestinal Rehabilitation Team, Samsung Medical Center, Sungkyunkwan University School of Medicine, South Korea;

关键词: Short bowel syndrome;    Intestinal rehabilitation;    Parenteral nutrition;    Intestinal failure-associated liver disease;    Central line-associated blood stream infection;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Type II (acute) intestinal failure (IF) is usually caused by complications of abdominal surgery resulting in enteric fistulas or proximal stomas and requires parenteral nutrition (PN) for several months. This study aimed to evaluate clinical management and outcome of type II IF patients in a single center. Methods: Medical records of patients referred to the Intestinal Rehabilitation Team (IRT) at Samsung Medical Center (Seoul, Korea) were retrospectively analyzed. Results: From 2014 to 2019, 34 patients with IF were referred. 28 patients were type II IF and were included in the analysis. There were 17 males and 11 females. Mean age of patients was 56.7 years. Pathophysiology of IF were high-output stoma in 16 cases, extensive bowel resection (with bowel in continuity) in 7 cases, and enterocutaneous fistula in 5 cases. The catastrophic events necessitating abdominal surgery in the patients were adhesive ileus in 9 cases, superior mesenteric artery thrombosis in 8 cases, internal herniation of bowel in 5 cases, traumatic bowel injury in 3 cases, and ischemic enteritis in 3 cases. Following medical and surgical rehabilitation, 10 patients (35.7%) were weaned off PN and overall mortality was 28.5%. Deaths were related to progression of underlying malignancies in 4 cases, liver failure in 3 cases, and sepsis in 1 case. Thirteen patients underwent surgery to restore bowel continuity. Six postoperative complications occurred in 4 patients (30.7%) and there were no postoperative mortalities. Conclusion: Standardized care including restorative surgery resulted in successful outcomes in type II IF patients in this cohort.

【 授权许可】

Unknown