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Long-term results of surgery for bowel lengthening

how many transplants are avoided, for which patients?

Hernandez, Francisco; Andres, Ane M.; Lopez-Santamaria, Manuel

Current Opinion in Organ Transplantation: April 2018 - Volume 23 - Issue 2 - p 207–211
doi: 10.1097/MOT.0000000000000508
SMALL BOWEL TRANSPLANTATION: Edited by Florence Lacaille
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Purpose of review One of the biggest successes of intestinal rehabilitation programs is that more patients achieve enteral autonomy without transplantation. Many factors are responsible of this accomplishment including new parenteral formulas, better catheter management, surgical management, and the experience of the teams. The purpose of this review is to analyze recent published papers regarding intestinal lengthening procedures trying to find out how many transplantations are avoided and for which patients.

Recent findings A trend towards performing less intestinal transplants has been identified in the last years. The general improvement of intestinal rehabilitation accounts for this step forward. However, the role of intestinal lengthening has not been clarified.

Summary Surgical techniques for autologous reconstructive surgery are not limited to bowel lengthening. Longitudinal intestinal lengthening and tailoring and serial transverse enteroplasty offered good results in terms of intestinal adaptation, long-term survival, and subsequent need of intestinal transplantation. In recent series, less than one quarter of patients who underwent intestinal lengthening required salvage intestinal transplantation.

Pediatric Surgery Service, La Paz University Hospital, Madrid, Spain

Correspondence to Francisco Hernandez, MD, Pediatric Surgery Service, Hospital Universitario La Paz, Paseo de La Castellana, 261, Madrid, Spain. Tel: +34 917277019; fax: +34 917277478; e-mail: fhernandezo@salud.madrid.org

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