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- Title
Management of Type 2 Intestinal Failure: Experience of a Korean Intestinal Rehabilitation Team.
- Authors
Sanghoon Lee; Hyo Jung Park; Jeong-meen Seo
- Abstract
Background/Aims Type 2 (acute) intestinal failure (IF) is caused by complications of abdominal surgery resulting in enteric fistulas or proximal stomas and usually requires parenteral nutrition (PN) for several months. This study aimed to evaluate clinical management and outcome of type 2 IF patients in a single center. Methods Medical records of patients referred to the Intestinal Rehabilitation Team (IRT) at Samsung Medical Center (Seoul, Korea) were retrospectively analyzed. Results From June 2014 to May 2019, 29 patients with IF were referred. Nineteen patients were type 2 IF and were included in the analysis. There were 11 males and eight females. Mean age of patients was 55.1 years. Underlying disease were malignant cancer in eight patients, cardiac disease in six patients, trauma in three patients, type 1 diabetes mellitus in one patient, and in one patient there were no known underlying diseases. All patients underwent laparotomy and bowel resection: due to mechanical obstruction with ischemia related to prior abdominal surgery in nine cases, superior mesenteric artery embolic infarct in five cases, traumatic bowel injury in three cases, and ischemic enteritis in two cases. Fifteen patients had proximal jejunostomies, three patients had enterocutaneous fistulae, and one patient had jejunoileal anastomosis done. Following medical and surgical rehabilitation, seven patients were weaned off PN, six patients went on to type 3 IF, and one patient is in the process of PN weaning after surgery. Seven patients died due to underlying malignancy (four patients) and IFALD (three patients). Eleven patients underwent surgery to restore bowel continuity. Median time from initial surgery to restorative surgery was 6.0 months (range, 2.3 to 19.8 months). Conclusions Standardized care including restorative surgery resulted in successful outcomes in type 2 IF patients in this cohort.
- Subjects
TYPE 1 diabetes; RESTORATIVE proctocolectomy; MESENTERIC artery; INTESTINE transplantation
- Publication
Gut & Liver, 2019, Vol 13, Issue 6(suppl. 1), p128
- ISSN
1976-2283
- Publication type
Article