Serial transverse enteroplasty and nipple valve construction, two life saving techniques for patients with short bowel syndrome, a report of 5 cases

• Published in: BMC surgery Vol. 21; no. 1; p. 446
• Main Authors: Shafiekhani, Mojtaba, Azadeh, Nazanin, Ashrafzadeh, Kiarash, Esmaeili, Maryam, Nikoupour, Hamed
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 30.12.2021; BioMed Central; BMC
• Subjects: Abdomen; Abdominal surgery; Absorptivity; Adaptation; Autografts; Autologous gastrointestinal reconstruction; Care and treatment; Case report; Case reports; Colon; Complications; Diagnosis; Digestive System Surgical Procedures; Enterocutaneous fistula; Fistula; Hospitals; Humans; Ileum; Inflammatory bowel disease; Intestinal adaptation; Intestinal failure; Intestinal transit time; Intestine; Intestine, Small - surgery; Ischemia; Laparotomy; Malabsorption syndromes; Malnutrition; Methods; Micronutrients; Mucosa; Nipples; Nutrition; Ostomy; Parenteral Nutrition; Patients; Quality of life; Serial transverse enteroplasty; Short bowel syndrome; Short Bowel Syndrome - surgery; Small intestine; Surgeons; Transit time; Transplantation; Valves; Autologous gastrointestinal reconstruction; Case report; Short bowel syndrome; Enterocutaneous fistula; Serial transverse enteroplasty; Intestinal failure
• ISSN: 1471-2482; 1471-2482
• DOI: 10.1186/s12893-021-01454-2

Various abdominal pathologies end up with surgical resection of small intestine. When the small intestine remnant is too short for adequate fluid and micronutrients absorption, short bowel syndrome is diagnosed. The disabling condition needs a multidisciplinary approach to design parenteral nutrition, care for thrombotic, hepatic and infectious complications and gradually wean the patient from parenteral nutrition. Various surgical techniques have been introduced to increase absorptive mucosa and enhance the intestinal adaptation process. Serial transverse enteroplasty and nipple valve reconstruction are among the procedures, which will be discussed in the current article. Herein, we presented 5 cases of short bowel syndrome as a consequence of abdominal laparotomies, patients were referred to our center to receive parenteral nutrition and to be prepared for the final autologous gastrointestinal reconstruction or intestinal transplantation, if indicated. Patient's age, performance status and bowel remnant length determines the appropriate technique for autologous gastrointestinal reconstruction. Serial transverse enteroplasty is designed to increase bowel's length by creating zigzag patterns through dilated bowel loops. Presence of ileocecal valve is crucial to delay intestinal transit time and to prevent colonic bacterial transfer to ileum. Patient's with ileocecal valve loss benefit from creating an artificial valve, namely, nipple valve.