Nontransplant Surgery for Intestinal Failure.

Riccardo Coletta, Antonino Morabito, Kishore Iyer

Journal: Gastroenterology clinics of North America 2020;48(4):565-574

PMID: 31668183

Full Text on Elsevier Science View on PubMed

Abstract

Insufficient absorptive mucosal surface is the fundamental problem in the short bowel state. Intestinal adaptation has been well studied, and it is well recognized that it may lead to dilatation of the bowel with increased thickness of the bowel wall, resulting from both mucosal hypertrophy and hyperplasia. Autologous reconstructive surgery exploits bowel dilatation in short bowel syndrome and maximizes the absorptive potential of the available mucosal surface. Indeed, autologous gastrointestinal reconstructive procedures may be better viewed as optimizing bowel diameter rather than focusing on length, thus allowing better prograde peristalsis and improved contact between luminal nutrients and mucosa, ultimately enhancing absorption.

Address: Department of Paediatric Surgery, Center for Intestinal Reconstruction and Rehabilitation, Meyer Children's Hospital, Viale Gaetanao Pieraccini. 24, Florence 50139, Italy; School of Environment and Life Science, University of Salford, Salford, UK.; Department of Paediatric Surgery, Center for Intestinal Reconstruction and Rehabilitation, Meyer Children's Hospital, Viale Gaetanao Pieraccini. 24, Florence 50139, Italy; School of Environment and Life Science, University of Salford, Salford, UK; Department of NeuroFarBa, University of Florence, Florence, Italy.; Intestinal Rehabilitation & Transplant Program, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave Levy Place, Box 1104, New York, NY 10029, USA. Electronic address: [email protected].

DOI: 10.1016/j.gtc.2019.08.009

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MeSH Terms: Digestive System Surgical Procedures, Dilatation, Pathologic, Gastrointestinal Transit, Humans, Intestines, Short Bowel Syndrome, Tissue Expansion