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"Intestinal rehabilitation"

Kwai Lam, Lauren Schwartz, Jennifer Batisti, Kishore R Iyer
BACKGROUND: Teduglutide is a glucagon-like peptide 2 (GLP-2) analog that has been approved for the treatment of adult short bowel syndrome (SBS)-associated intestinal failure (IF; SBS-IF). Teduglutide increases villus height and crypt depth in the small bowel mucosa, promoting nutrition absorption and enteral independence from parenteral nutrition (PN). We aim to report our single-center experience with teduglutide in adult patients with SBS to provide real-world context to its use. METHOD: We conducted a retrospective analysis on patients managed within our tertiary-level intestinal rehabilitation program to identify patients with SBS-IF treated with teduglutide from 2009-2015...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Jason S Hawksworth, Chirag S Desai, Khalid M Khan, Stuart S Kaufman, Nada Yazigi, Raffaele Girlanda, Alexander Kroemer, Thomas M Fishbein, Cal S Matsumoto
Intestine failure-associated liver disease (IFALD) is widely recognized as a lethal complication of long-term parenteral nutrition. The pathophysiology of IFALD is poorly understood but appears to be multifactorial and related to the inflammatory state in the patient with intestinal failure (IF). Visceral transplantation for IFALD includes variants of intestine, liver, or combined liver and intestine transplantation. Graft selection for an individual patient depends on the etiology of intestinal failure, abdominal and vascular anatomy, severity of IFALD, and potential for intestinal rehabilitation...
March 2, 2018: American Journal of Transplantation
Lorenzo Norsa, Solene Artru, Cecile Lambe, Cecile Talbotec, Benedicte Pigneur, Frank Ruemmele, Virginie Colomb, Carmen Capito, Christophe Chardot, Florence Lacaille, Olivier Goulet
BACKGROUND & AIMS: Intestinal rehabilitation is the preferred treatment for children with short bowel syndrome (SBS) whatever the residual bowel length, and depends on the accurate management of long-term parenteral nutrition (PN). If nutritional failure develops, intestinal transplantation (ITx) should be discussed and may be life-saving. This study aimed to evaluate survival, PN dependency and nutritional status in children with neonatal very SBS on PN or after ITx, in order to define indications and timing of both treatments...
February 15, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Frank Daniel Martos-Benítez, Anarelys Gutiérrez-Noyola, Andrés Soto-García, Iraida González-Martínez, Ilionanys Betancourt-Plaza
Nutritional depletion is commonly observed in patients undergoing surgical treatment for a gastrointestinal malignancy. An appropriate nutritional intervention could be associated with improved postoperative outcomes. The study was aimed to determine the effect of a program of gastrointestinal rehabilitation and early postoperative enteral nutrition upon complications and clinical outcomes in patients who experienced gastrointestinal surgery for cancer. This is a prospective study (2013 January-2015 December) of 465 consecutive patients submitted to gastrointestinal surgery for cancer and admitted to an Oncological Intensive Care Unit...
February 10, 2018: Updates in Surgery
Francisco Hernandez, Ane M Andres, Manuel Lopez-Santamaria
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...
February 5, 2018: Current Opinion in Organ Transplantation
Christina Belza, Kevin Fitzgerald, Nicole de Silva, Yaron Avitzur, Karen Steinberg, Glenda Courtney-Martin, Paul W Wales
OBJECTIVE: The primary goal in intestinal failure (IF) is adaptation and enteral autonomy (EA). Our goals were to determine the proportion of patients treated for IF by an established intestinal rehabilitation program who achieved EA and to assess the predictors of EA. BACKGROUND: There have been considerable advancements in the management of IF over the last 15 years, children with short bowel syndrome with a reduction in mortality. Several studies have discussed variables that may influence the ability to attain EA; however, majority were written when mortality rates were considerably higher compared with the current contemporary experience...
December 4, 2017: Annals of Surgery
A Lauro, R Cirocchi, N Cautero, A Dazzi, D Pironi, F M Di Matteo, A Santoro, L Pironi, A D Pinna
A systematic bibliographic research concerning patients operated on for SBS was performed: inclusion criteria were adult age, reconnection surgery and SBS < 100 cm. Autologous gastrointestinal reconstruction represented an exclusion criteria. The outcomes of interest were the rate of total parenteral nutrition (TPN) independence and the length of follow-up (minimum 1 year) after surgery. We reviewed our experience from 2003 to 2013 with minimum 1-year follow-up, dealing with reconnection surgery in 13 adults affected by < 100 cm SBS after massive small bowel resection: autologous gastrointestinal reconstruction was not feasible...
July 2017: Il Giornale di Chirurgia
Kwai Lam, Thomas Schiano, Maria Isabel Fiel, Kishore Iyer
Long-term parenteral nutrition (PN) may be complicated by PN-associated liver disease (PNALD), and some studies suggest an association between the use of soy-based fat emulsions and PNALD development. Patients' liver function typically improves and PNALD resolves after reducing or stopping a soy-based fat emulsion, and thus lipid minimization has been the primary strategy for managing PNALD in many intestinal rehabilitation programs. However, fat emulsions often cannot be stopped entirely, leading some patients to develop PNALD even after lipid reduction strategies have been implemented...
November 2017: JPEN. Journal of Parenteral and Enteral Nutrition
Guohao Wu
Patients with short bowel syndrome suffer from fluid and electrolyte imbalance and malabsorption due to poor nutrient processing capability of the residual intestine. Nutritional support therapy has been considered as one of the important treatments for short bowel syndrome. For patients with short bowel syndrome, a deep understanding of metabolic changes, and then rational application of nutritional support therapy and intestinal rehabilitation program can save many patients' lives, improve quality of life, and even achieve independence from parenteral nutrition, and return to a normal life...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Kyle A Soltys, Geoff Bond, Rakesh Sindhi, Sara K Rassmussen, Armando Ganoza, Ajai Khanna, George Mazariegos
The field of intestinal transplantation has experienced dramatic growth since the first reported cases 3 decades ago. Improvements in operative technique, donor assessment and immunosuppressive protocols have afforded children who suffer from life-threatening complications of intestinal failure a chance at long-term survival. As experience has grown, newer diseases, with more systemic manifestations have arisen as potential indications for transplant. After discussing the historical developments of intestinal transplant as a backdrop, this review focuses on the specific pre-operative indications for transplant as well as the great success that intestinal rehabilitation has witnessed over the past decade...
August 2017: Seminars in Pediatric Surgery
Patrick J Javid, Assaf P Oron, Christopher Duggan, Robert H Squires, Simon P Horslen
BACKGROUND: The advent of regional multidisciplinary intestinal rehabilitation programs has been associated with improved survival in pediatric intestinal failure. Yet, the optimal timing of referral for intestinal rehabilitation remains unknown. We hypothesized that the degree of intestinal failure-associated liver disease (IFALD) at initiation of intestinal rehabilitation would be associated with overall outcome. METHODS: The multicenter, retrospective Pediatric Intestinal Failure Consortium (PIFCon) database was used to identify all subjects with baseline bilirubin data...
September 5, 2017: Journal of Pediatric Surgery
Akshay Batra, Simon Charlie Keys, Mark John Johnson, Robert A Wheeler, Robert Mark Beattie
Ultrashort bowel syndrome (USBS) is a group of heterogeneous disorders where the length of small bowel is less than 10 cm or 10% of expected for the age. It is caused by massive loss of the gut which in the neonatal period can be a result of vanishing gastroschisis or surgical resection following mid-gut volvulus, jejunoileal atresia and/or extensive necrotising enterocolitis. The exact prevalence of USBS is not known although there is a clear trend towards increasing numbers because of increased incidence and improved survival...
November 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
Giorgia Totonelli, Roberto Tambucci, Alessandro Boscarelli, Dominique Hermans, Luigi Dall'Oglio, Antonella Diamanti, Aloys du Bois d'Aische, Mikko Pakarinen, Raymond Reding, Francesco Morini, Pietro Bagolan, Fabio Fusaro
No abstract text is available yet for this article.
August 24, 2017: European Journal of Pediatric Surgery
Russell J Merritt, Valeria Cohran, Bram P Raphael, Timothy Sentongo, Diana Volpert, Brad W Warner, Praveen S Goday
Intestinal failure is a rare, debilitating condition that presents both acute and chronic medical management challenges. The condition is incompatible with life in the absence of the safe application of specialized and individualized medical therapy that includes surgery, medical equipment, nutritional products, and standard nursing care. Intestinal rehabilitation programs are best suited to provide such complex care with the goal of achieving enteral autonomy and oral feeding with or without intestinal transplantation...
November 2017: Journal of Pediatric Gastroenterology and Nutrition
Anita M Nucci, Kipp Ellsworth, Austin Michalski, Emily Nagel, Jackie Wessel
BACKGROUND: Nutrition management of pediatric intestinal failure (IF) requires interdisciplinary coordination of parenteral nutrition (PN) and enteral nutrition (EN) support. Nutrition strategies used by specialists in pediatric intestinal rehabilitation to promote gut adaptation and manage complications have not been previously summarized. METHODS: A practice survey was distributed to members of the dietitian subgroup of the American Society for Parenteral and Enteral Nutrition Pediatric Intestinal Failure Section...
July 1, 2017: Nutrition in Clinical Practice
(no author information available yet)
No abstract text is available yet for this article.
June 2017: Transplantation
María Elena Molina, Felipe Bellolio, Julieta Klaassen, Javier Gómez, Constanza Villalón, Juan Francisco Guerra, Álvaro Zúñiga
BACKGROUND: In patients suffering intestinal failure due to short bowel, the goal of an Intestinal Rehabilitation Program is to optimize and tailor all aspects of clinical management, and eventually, wean patients off lifelong parenteral nutrition. AIM: To report the results of our program in patients suffering intestinal failure. PATIENTS AND METHODS: A registry of all patients referred to the Intestinal Failure unit between January 2009 and December 2015 was constructed...
November 2016: Revista Médica de Chile
Christina Belza, Paul W Wales
PURPOSE OF REVIEW: To review the recent literature related to the impact of an intestinal rehabilitation program (IRP) on the management of intestinal failure in children. RECENT FINDINGS: As publication of a systematic review of pediatric IRPs in 2013, there have been four publications further describing the impact of IRPs in children with intestinal failure. The results continue to support an improvement in survival and enteral autonomy, and a decrease in complications related to liver dysfunction, central venous catheters, and transplantation...
June 2017: Current Opinion in Pediatrics
Ludger Sieverding, Andreas Busch, Jens Gesche, Gunnar Blumenstock, Ekkehard Sturm, Ilias Tsiflikas, Femke Piersma, Anja Hauser, Gesa Wiegand, Steffen Hartleif, Michael Hofbeck, Jörg Fuchs, Steven W Warmann
PURPOSE: The purpose of this study is to analyze the combined approach of endovascular and open surgical procedures for insertion of permanent central venous catheters in children with intestinal failure and end-stage venous access. METHODS: Data of 14 children (16 interventions) with intestinal failure and end-stage venous access, treated within the pediatric intestinal rehabilitation program at our institution between September 2011 and November 2016, were retrospectively reviewed...
March 24, 2017: Journal of Pediatric Surgery
Danielle L Morton, Keli M Hawthorne, Carolyn E Moore
Objective. Infants with intestinal failure or feeding intolerance are nutritionally compromised and are at risk for extrauterine growth restriction. The aim of the study was to evaluate growth velocities of infants with intestinal failure and feeding intolerance for the first three months of age and to determine growth percentiles at birth and at 40-week postmenstrual age (PMA). Methods. A chart review of infants followed by the Texas Children's Hospital Intestinal Rehabilitation Team was conducted from April 2012 to October 2014...
2017: Journal of Nutrition and Metabolism
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