SHORT BOWEL SYNDROME AND CHRONIC INTESTINAL FAILURE: ASSESSMENT OF PROGNOSTIC MARKERS AND EFFECTIVENESS OF REHABILITATION

Cover Page


Cite item

Full Text

Abstract

Introduction. The survival rate of children with chronic intestinal failure (IF), a special case of which is short bowel syndrome (SBS), is increasing nowadays. The experience of a 4-stage system of care for children with chronic intestinal failure (IF) and short bowel syndrome (SBS) developed in Children’sCityHospital named after N. F. Filatov is presented. 

Objectives. The aim was to identify prognostic markers for intestinal adaptation (IA) in children with an extended (more than50 cm) resections of the intestine.

 Methods. The outcomes were evaluated in 75 children one year after resection and its relations to the preserved small intestine length, extension and cause of resection.

 Results. Survival of children after 1 and 3 years was 87–89%. The proportion of those who have reached IA was higher (38%) in children with more than60 cm remaining intestine in comparing to those who have less than30 cm and 30–60 cm of intestine (14.5–15%) (p <0.05. After combined resections of intestine and colon more children were dependent on PN (90%) then after intestinal (46%) or colon resections (41%) (p <0.05). Children with acute strangulation and intestinal malformations better achieved IA (50% and 44%) compared with those who underwent resection for necrotizing enterocolitis or diff intestinal neuroand myopathies (0% of IA by 1 year after resection) (р<0,05). By 1 year of following up (N=75) 25% achieved IA, 46% remained dependent on the PN, by 3 years (N=32) 44% achieved IA, 39% were dependent on PN. Conclusion. The remaining intestinal length, extension of resection and the underlying disease infl on 1-year prognosis in children with intestinal resections. Increasing in those who have achieved AI in the course of time allows to conclude that children with IF and SBS have a rehabilitation potential and the developed RP is eff in such patients.

About the authors

A. I. Chubarova

Russian National Research Medical University named after N.I. Pirogov;
Children’s City Hospital named after N.F. Filatov

Author for correspondence.
Email: dgkb13@zdrav.mos.ru
ЧУБАРОВА Антонина Игоревна – доктор медицинских наук, профессор кафедры госпитальной педиатрии им. академика В. А. Таболина ГБОУ ВПО РНИМУ им. Н. И. Пирогова, главный врач ДГКБ № 13 им. Н. Ф. Филатова Russian Federation

E. A. Kostomarova

Russian National Research Medical University named after N.I. Pirogov;
Children’s City Hospital named after N.F. Filatov

Email: eleni@abloy.ru
КОСТОМАРОВА Елена Андреевна – аспирант кафедры госпитальной педиатрии, врач-педиатр отделения хирургии новорожденных ДГКБ № 13 им. Н. Ф. Филатова Russian Federation

N. S. Zhikhareva

Children’s City Hospital named after N.F. Filatov

Email: pediatricus@outlook.com
ЖИХАРЕВА Наталья Сергеевна – зав. педиатрическим отделением Russian Federation

References

  1. Ерпулева Ю. В., Чубарова А. И. Современное ведение детей с синдромом короткой кишки и другими формами хронической кишечной недостаточности. Пособие для врачей. /Москва, 2016; издательская группа ГЭОТАР-Медиа; Eerpuleva Y. V., Chubarova A. I. Management of children with short bowel syndrome and other forms of chronic intestinal failure. The guidelines. / Moscow, 2016; GEOTAR-Media (in Russian);
  2. Pironi L. et al. ESPEN endorsed recommendation. Definition and classification of intestinal failure in adults. / Clinical Nutrition 34 (2015), 171–180;
  3. Tannuri U., Barros de F., Tannuri A. Treatment of short bowel syndrome in children. Value of the Intestinal Rehabilitation Programme. Rev.Assoc.Med.Bras., 2016, p.575–583;
  4. 4. Wales P. W., Silva N.and Kim J., et al. Neonatal short bowel syndrome: population-based estimates of incidence and mortality rates. J. Pediatr.Serg. 39 (5); 2004; p.690–695.
  5. Schalamon J., Mayer J. M. and Hollwarth M. E. Mortality and economics in short bowel syndrome. Best Pract Res Clin Gastroenerol. 17 (6);2003; 931–942;
  6. Goulet O. J., Revillon Y. and Jan D., et al. Neonatal short bowel syndrome. J. Pediatr. 119 (1) (Pt 1): 1991; p. 18–23;
  7. Лечение детей с синдромом короткой кишки. Федеральные клинические рекомендации российской ассоциации детских хирургов. Российский вестник детской хирургии, анестезиологии и реаниматологии. 2014; 4; 4: 92–108; Treatment of children with short bowel syndrome and other forms of chronic intestinal failure. Clinical recommendations of the Russian Association of Pediatric Surgeons. Russian annals of pediatric surgery, anesthesiology and resuscitation. 2014; 4; 4: 92–108 (in Russian);
  8. Чубарова А. И., Ерпулева Ю. В., Аверьянова Ю. В., Костомарова Е. А. Пособие для родителей детей, нуждающихся в длительном парентеральном питании. – М., 2017. – 104 с.: ил., издательская группа ГЭОТАР-Медиа; Chubarova A. I, Erpuleva Y. V., Averyanova Y. V., Kostomarova E. A. A manual for parents of children needed long-term parenteral nutrition. – M., 2017. – 104 p.: ill., GEOTAR-Media (in Russian);
  9. Гастроэнтерология и питание / Д. Нью; под ред. Р. Полина; пер. с англ.; под ред. Ю. Г. Мухиной. – М.: Логосфера, 2014. – 512 с.; 18,4 см. – (Проблемы и противоречия в неонатологии). Gastroenterology and nutrition / D. New; Ed. R. Polin; trans. from the English; Ed. SOUTH. Fly. – Moscow: Logosfera, 2014. – 512 p.; 18.4 cm. – (Problems and contradictions in neonatology);
  10. Основы клинического питания / гл.ред. Соботка Л., изд. 4, 2011 год; пер.с англ.под ред. Свиридова С. В., Шестопалова А. Е.; издательская группа ГЭОТАР-Медиа; Basis of clinical nutrition / main ed. Sobotka L., ed. 4, 2011; trans. from English ed. Sviridov S. V., Shestopalov A. E.; GEOTAR-Media$
  11. Buchman A. L., Scolapio J., Fryer J.J. AGA Technical review on short bowel syndrome and intestinal transplantation Gastroenterology 2003; 124: 1111–34.
  12. Spenser et al. Pediatric short bowel syndrome. Redefining Predictors of Success. Annals of Surgery, Vol 242, Numb. 3, September 2005; р. 403–411.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2017 Chubarova A.I., Kostomarova E.A., Zhikhareva N.S.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: ПИ № ФС 77 - 81892 от 24.09.2021 г.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies