Evaluation of intestinal absorption after longitudinal intestinal lengthening for short bowel syndrome
Evaluation of intestinal absorption after longitudinal intestinal lengthening for short bowel syndrome
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DOI：
10.1016/j.jpedsurg.2005.06.003
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发表时间：
2005-10-01
影响因子：
2.4
通讯作者：
de Lagausie, P
中科院分区：
文献类型：
--
作者：
Bonnard, A;Staub, G;de Lagausie, P
目的：本研究的目的是回答由Aigrain改良的比安奇的纵向肠延长和剪裁（LILT）是否可以使儿童脱离肠外营养（PN），以及手术后肠的长度是否会影响吸收试验（如Schilling或D-木糖试验）的结果。患者和方法：我们回顾了1980年至2003年7名患有LILT的儿童的档案。我们进行了两项肠功能试验：D-木糖和Schilling试验。两者均在LILT后早期（术后第一年）和晚期（第二年）进行。结果：男6例，女1例，均为男性，男1例，女1例。手术适应证为多发性肠闭锁引起的肠外营养短肠综合征（2例）、严重坏死性小肠结肠炎伴肠扭转（1例）、坏死性小肠结肠炎（1例）、肠闭锁伴腹裂（2例）和旋转不良引起肠扭转（1例）。肠长度在LILT前后有显著性差异（P < .0001）。LILT后，6个月（P = .02）和12个月（P = .001）时肠道长度与PN油能量百分比显着相关。此外，手术后的肠道长度与第一年的D-木糖试验结果显著相关（P = 0.002），但与第二年后的结果无关。延长后的长度既不影响第一年的希林试验结果，也不影响第二年的希林试验结果。4例患者在LILT后平均21个月脱离PN（57%）; 1例未脱离PN，因为我们仅进行了2个月的随访。平均随访Lip为111（5个月;范围，4-206）。结论：短肠综合征的纵向肠延长和剪裁是一个很好的选择，让儿童从PN断奶。手术后肠的长度在术后第一年影响D-木糖等吸收试验，但在第二年不影响，也不影响希林试验。我们认为在这些患者的随访期间没有必要进行这些检查。(c)2005年由Elsevier Inc.出版
Purpose: The aim Of this Study was to answer if the longitudinal intestinal lengthening and tailoring (LILT) by Bianchi, modified by Aigrain, can allow the child to be weaned from parenteral nutrition (PN) and if the length of the bowel after the procedure call influence the results of the absorption test Such as Schilling or D-xylose test.Patients and Methods: We reviewed the files of 7 children who have had LILT From 1980 to 2003. We performed to explore 2 intestinal function tests: the D-xylose and the Schilling tests. Both were performed early (during the first year after the procedure) and late (during the second year) after the LILT. We used the chi(2) and Bartlett's correlation tests for statistical analysis.Results: There were 6 boys and 1 girl. The Surgical indication was short bowel syndrome with parenteral nutrition owing to multiple intestinal atresia (2 cases), severe necrotizing enterocolitis with volvulus (1 case), necrotizing enterocolitis (I case), intestinal atresia with gastroschisis (2 cases), and volvulus Owing to malrotation (1 case). The length of the bowel was significantly different before and after LILT (P < .0001). After LILT, the length of the bowel was significantly correlated with the percentage of PN oil energy at 6 months (P = .02) and at 12 months (P = .001). Moreover, the length of the bowel after the procedure was significantly correlated with the results of the D-Xylose test during the first year (P = .002) but not with the results after the second year. The length after lengthening influenced neither the results of the Schilling test during the first nor those of the second year after. Four patients were weaned from the PN 21 months in average after the LILT (57%); 1 was not because we had only a 2-month follow-up. The average follow-Lip was 111 (5 months; range, 4-206).Conclusion: Longitudinal intestinal lengthening and tailoring for short bowel syndrome is a good option to allow children to be weaned from the PN. The length of the bowel after the procedure call influence the absorption test such as D-xylose during the first postoperative year but not during the second and does not influence the Schilling test. We think it is not necessary to perform these tests during the follow-up of these patients. (c) 2005 Published by Elsevier Inc.