Alimentary TractLong-term survival and parenteral nutrition dependence in adult patients with the short bowel syndrome☆
Section snippets
Patients
From January 1980 to December 1992, all consecutive adult patients with short bowel syndrome defined as remnant postduodenal small bowel length of ≤150 cm, half the shortest normal small bowel length in adults,10 were included in the study. Data collection ended in April 1996. Bowel rehabilitation strategies, i.e., growth hormone treatment,13 surgically reversed small bowel loop,14 and intestinal transplantation, were then implemented at 1 of the 2 centers involved (Saint-Lazare Hospital). We
Patient characteristics
One hundred twenty-seven patients fulfilled inclusion criteria; 3 patients were lost to follow-up. Thus, 124 patients aged 52 years (range, 17–87) at time of short bowel constitution were available for analysis. Their demographic and digestive characteristics are shown in Tables 1 and 2, respectively.
Characteristics No. of patients (%) Sex Male 62 (50) Female 62 (50) Age at time of short bowel constitution (yr) ≤40
Discussion
We report survival and PN-dependence probabilities of 75% and 45% at 5 years, respectively, in a cohort of 124 adults with nonmalignant short bowel syndrome, enrolled within a 13-year period of study. In multivariate analysis, survival was negatively related to digestive circuit type 1 (end-enterostomy), to small bowel length of <50 cm, and to arterial infarction as a cause for bowel resection, but not to PN dependence. After correction taking into account other causes of death through use of
Acknowledgements
The authors thank J. Barbier, M. Beliah, J. J. Bernier, Y. Bouhnik, B. Coffin, M. Lémann, P. Hautefeuille, V. de Ledhingen, R. Modigliani, Y. Panis, J. C. Rambaud, and P. Valleur for follow-up of the patients; and J. Arsham and D. Pryce for the English revision of the manuscript.
References (44)
Evaluating a mature technology: long-term home parenteral nutrition
Gastroenterology
(1995)- et al.
Current use and clinical outcome of home parenteral therapies in the United States
Gastroenterology
(1995) - et al.
Home parenteral nutrition in adults: a multicentre survey in Europe in 1993 ESPEN-Home Artificial Nutrition Working Group
Clin Nutr
(1996) - et al.
Prognosis of patients with nonmalignant chronic intestinal failure receiving long-term home parenteral nutrition
Gastroenterology
(1995) Current results of intestinal transplantation
Lancet
(1996)- et al.
Nutritional support and therapy in the short bowel syndrome
Gastroenterol Clin North Am
(1989) - et al.
Jejunal efflux in short bowel syndrome
Lancet
(1990) - et al.
Segmental reversal of the small bowel as an alternative to intestinal transplantation in patients with short bowel syndrome. A report of 11 cases
Clin Nutr
(1998) - et al.
Intestinal absorption of free oral hyperalimentation in the very short bowel syndrome
Gastroenterology
(1991) - et al.
Neonatal short bowel syndrome
J Pediatr
(1991)
Short-bowel syndrome in children and adults
Gastroenterology
Factors correlating with a successful outcome following extensive intestinal resection in new-born infants
J Pediatr
Colon as a digestive organ in patients with short bowel
Lancet
Bacterial adaptation in patients with short bowel and colon in continuity
Gastroenterology
Importance of colonic support for energy absorption as small bowel failure proceeds
Am J Clin Nutr
Small intestinal transplantation: reflections on an evolving approach to intestinal failure
Gastroenterology
A cost-utility analysis of the HPN program at Toronto General Hospital: 1970–1982
J Parenter Enteral Nutr
Four years of North American registry home parenteral nutrition outcome data and their implications for patients management
J Parenter Enteral Nutr
Long term parenteral nutrition: clinical experience in 70 patients from 1967 to 1980
Scand J Gastroenterol
Clinical problems of short bowel and their treatment
Proc Nutr Soc
Colonic preservation reduces need for parenteral therapy, increases incidence of renal stones, but does not change high prevalence of gallstones in patients with a short bowel
Gut
Growth hormone benefit in very short bowel patients: a randomized controlled trial
Gastroenterology
Cited by (523)
Cost-effectiveness of teduglutide in adult patients with short bowel syndrome – a European socioeconomic perspective
2024, American Journal of Clinical NutritionESPEN guideline on chronic intestinal failure in adults – Update 2023
2023, Clinical NutritionOrally compensated short bowel patients are thin, potentially malnourished but rarely sarcopenic
2023, Clinical NutritionMortality and parenteral nutrition weaning in patients with chronic intestinal failure on home parenteral nutrition: A 30-year retrospective cohort study
2023, NutritionCitation Excerpt :Most of HPN weaning in our patients occurred within the first 2 y due to the intestinal adaptation usually occurring in the first years after the intestinal circuit modification [10,15,18,25]. Younger age (in individuals without SBS) and increased bowel length (in SBS individuals) were significantly associated with the likelihood of being weaned from HPN in our patients, consistent with the literature [3,8,10,20,24]. However, we have considered intestinal anatomy as a time-dependent datum, allowing a more precise correlation between gut circuit and weaning probability.
Evaluation of the Effectiveness of Teduglutide Treatment in Patients with Short Bowel Syndrome in Slovakia—Multicenter Real-World Study
2024, Journal of Clinical Medicine
- ☆
Address requests for reprints to: Bernard Messing, M.D., Department of Hepatogastroenterology and Nutrition support, Hôpital Lariboisière, 2 rue Ambroise Paré, 75475 Paris Cedex 10, France. e-mail: [email protected]; fax: (33) 01-4995-2544.