Results of Intestinal Rehabilitation in Patients With Short Bowel Syndrome With Residual Intestinal Length Less than 1 Meter
Introduction: Short bowel syndrome (SBS) associated with intestinal failure (IF) is defined as a state of transient intestinal insufficiency characterized by abundant enterostomy losses leading to electrolyte disturbances, malabsorption and malnutrition. In Peru, it occurs mainly as a result of inte...
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| Lenguaje: | inglés |
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2017
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| _version_ | 1881700430882275328 |
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| author | Sergio Zegarra Eduardo Huaman |
| author_browse | Eduardo Huaman Sergio Zegarra |
| author_facet | Sergio Zegarra Eduardo Huaman |
| author_sort | Sergio Zegarra |
| collection | Producción científica |
| description | Introduction: Short bowel syndrome (SBS) associated with intestinal failure (IF) is defined as a state of transient intestinal insufficiency characterized by abundant enterostomy losses leading to electrolyte disturbances, malabsorption and malnutrition. In Peru, it occurs mainly as a result of intestinal ischemia and postoperative complications. The management of SBS by the Specialized Units has improved survival, however when residual intestinal length (RIL) is less than 1 meter there are factors in the treatment that are determinants for survival and analyzed in the present study. Patient Materials and Methods: Adult patients with a diagnosis of SBS associated with IF were selected, older than 18 years with RIL greater than or less than 1 meter. In addition, group A (2011-2013) was differentiated where patients were treated in a conventional way and in group B (2014-2016) where a rigid protocol was implemented for their management. Statistical package STATA-11 was used. Results: Between 2011 and 2016, 79 patients with a diagnosis of SBS associated to IF were treated. 34 of them with RIL less than 1 meter. Mortality was significantly higher in this group of patients (68% vs. 42% OR 2.8 IC 1.0-8.1, p <0.05 fraction attributable 65%); Mortality Autologous Gastrointestinal Reconstruction (AGIR) was also higher (46% vs. 21% p<0.05). When comparing both groups (A and B), they had the same behavior regarding a higher mortality when they had lower RIL. However, patients with RIL less than 1 meter had greater survival if they achieved enteral access (p < 0.05), received enteral glutamine (p < 0.05), AGIR (p < 0.05) and if they did not receive exclusive Parenteral Nutrition (ns). Conclusion: We found that the survival of the SBS associated with IF is directly related to the RIL; could also be associated with having enteral access, receiving enteral nutrition with glutamine and performing AGIR. In addition, a better evolution of patients was found in group B, in which a management protocol was established. |
| format | Article |
| id | openalex:W2661212380 |
| institution | UPeU |
| language | English |
| publishDate | 2017 |
| publishDateRange | 2017 |
| publishDateSort | 2017 |
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| spelling | openalex:W2661212380Results of Intestinal Rehabilitation in Patients With Short Bowel Syndrome With Residual Intestinal Length Less than 1 MeterSergio ZegarraEduardo Huamanshort bowel syndromeintestinal failureintestinal rehabilitationmortalityenteral nutritionglutamineparenteral nutritionmanagement protocolintestinal ischemiaPeruClinical Nutrition and GastroenterologyAbdominal vascular conditions and treatmentsAbdominal Surgery and ComplicationsIntroduction: Short bowel syndrome (SBS) associated with intestinal failure (IF) is defined as a state of transient intestinal insufficiency characterized by abundant enterostomy losses leading to electrolyte disturbances, malabsorption and malnutrition. In Peru, it occurs mainly as a result of intestinal ischemia and postoperative complications. The management of SBS by the Specialized Units has improved survival, however when residual intestinal length (RIL) is less than 1 meter there are factors in the treatment that are determinants for survival and analyzed in the present study. Patient Materials and Methods: Adult patients with a diagnosis of SBS associated with IF were selected, older than 18 years with RIL greater than or less than 1 meter. In addition, group A (2011-2013) was differentiated where patients were treated in a conventional way and in group B (2014-2016) where a rigid protocol was implemented for their management. Statistical package STATA-11 was used. Results: Between 2011 and 2016, 79 patients with a diagnosis of SBS associated to IF were treated. 34 of them with RIL less than 1 meter. Mortality was significantly higher in this group of patients (68% vs. 42% OR 2.8 IC 1.0-8.1, p <0.05 fraction attributable 65%); Mortality Autologous Gastrointestinal Reconstruction (AGIR) was also higher (46% vs. 21% p<0.05). When comparing both groups (A and B), they had the same behavior regarding a higher mortality when they had lower RIL. However, patients with RIL less than 1 meter had greater survival if they achieved enteral access (p < 0.05), received enteral glutamine (p < 0.05), AGIR (p < 0.05) and if they did not receive exclusive Parenteral Nutrition (ns). Conclusion: We found that the survival of the SBS associated with IF is directly related to the RIL; could also be associated with having enteral access, receiving enteral nutrition with glutamine and performing AGIR. In addition, a better evolution of patients was found in group B, in which a management protocol was established.Articlehttps://doi.org/10.1097/01.tp.0000521519.95937.3bW2661212380enTransplantation0041-13371534-60802017-06-01 |
| spellingShingle | short bowel syndrome intestinal failure intestinal rehabilitation mortality enteral nutrition glutamine parenteral nutrition management protocol intestinal ischemia Peru Clinical Nutrition and Gastroenterology Abdominal vascular conditions and treatments Abdominal Surgery and Complications Sergio Zegarra Eduardo Huaman Results of Intestinal Rehabilitation in Patients With Short Bowel Syndrome With Residual Intestinal Length Less than 1 Meter |
| title | Results of Intestinal Rehabilitation in Patients With Short Bowel Syndrome With Residual Intestinal Length Less than 1 Meter |
| title_full | Results of Intestinal Rehabilitation in Patients With Short Bowel Syndrome With Residual Intestinal Length Less than 1 Meter |
| title_fullStr | Results of Intestinal Rehabilitation in Patients With Short Bowel Syndrome With Residual Intestinal Length Less than 1 Meter |
| title_full_unstemmed | Results of Intestinal Rehabilitation in Patients With Short Bowel Syndrome With Residual Intestinal Length Less than 1 Meter |
| title_short | Results of Intestinal Rehabilitation in Patients With Short Bowel Syndrome With Residual Intestinal Length Less than 1 Meter |
| title_sort | results of intestinal rehabilitation in patients with short bowel syndrome with residual intestinal length less than 1 meter |
| topic | short bowel syndrome intestinal failure intestinal rehabilitation mortality enteral nutrition glutamine parenteral nutrition management protocol intestinal ischemia Peru Clinical Nutrition and Gastroenterology Abdominal vascular conditions and treatments Abdominal Surgery and Complications |
| topic_facet | short bowel syndrome intestinal failure intestinal rehabilitation mortality enteral nutrition glutamine parenteral nutrition management protocol intestinal ischemia Peru Clinical Nutrition and Gastroenterology Abdominal vascular conditions and treatments Abdominal Surgery and Complications |
| url | https://doi.org/10.1097/01.tp.0000521519.95937.3b |
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