Nutritional Outcomes of Bowel Lengthening Procedure in Patients with Short Bowel Syndrome

TL;DR

Bowel lengthening procedures in patients with short bowel syndrome reduce the need for parenteral nutrition and improve nutritional outcomes over time.

Contribution

This study demonstrates that bowel lengthening procedures significantly decrease parenteral nutrition dependence in short bowel syndrome patients.

Findings

There was a significant decrease in PN volume and percentage of caloric intake via PN after bowel lengthening procedures.

Two patients were weaned off PN entirely following the procedure.

Nutritional improvements were most evident after six months and at long-term follow-up.

Abstract

Background: Although parenteral nutrition (PN) significantly improves mortality rates in pediatric short bowel syndrome (SBS), long-term PN has many possible complications and impacts quality of life. Bowel lengthening procedures (BLPs) increase the contact surface of food and the intestinal mucosa and enable the better absorption of nutrients and liquids, possibly leading to a PN decrease. Methods: We retrospectively reviewed the data of patients with short bowel syndrome who underwent BLPs in the period from January 2016 to January 2022. Overall, eight patients, four male, five born prematurely, underwent BLPs. Results: There was a significant decrease in the percentage of total caloric intake provided via PN and PN volume after the BLPs. The more evident results were seen 6 months after the procedure and at the last follow-up, which was, on average, 31 months after the procedure. Two patients were weaned off PN after their BLPs. Patients remained well nourished during the follow-up. Conclusions: The BLP led to a significant decrease in PN needs and an increase in the food intake; however, significant changes happened more than 6 months after the procedure.

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