Abstract
Aim The aim of this study was to report our initial experience using spiral intestinal
lengthening and tailoring (SILT) technique in selected cases of short bowel syndrome
(SBS).
Materials and Methods We analyzed all cases of SBS underwent SILT in our unit since the introduction of
the procedure in 2012. We retrospectively analyzed patients' demographics, pre- and
postprocedure bowel length, surgical complications, and postoperative parenteral nutrition
(PN) requirements. Data were compared using independent samples, Mann–Whitney's U-test.
Results Five children with SBS underwent SILT between 2012 and 2017. Median age at procedure
was 8.3 months (4.5–16). Preoperative small bowel length measured a median of 22 cm
(17.5–50) with a median diameter of 4 cm (3.5–4.6). SILT allowed a median increase
in length of 56% (10–15 cm; p = 0.03) and tailoring of the dilated segment providing a reduction in diameter of
50% (4.3–2.1 cm; p = 0.01). No major complications related to SILT were encountered and none of the
children required further surgical intervention following a median follow-up of 26
months (14.5–41). Interestingly, we observed a significant reduction of PN requirement
at 6 months (p = 0.008) associated with liver function preservation during the follow-up period.
Conclusion In our experience, SILT is a promising adjunct in the surgical management of SBS.
It can be used to tailor and lengthen mildly dilated segments of the bowel where other
procedures are technically challenging, with a view to reduce the risk of intestinal
failure associated liver disease and thereby improving chances for quality survival.
Further studies are needed to investigate long-term outcomes of SILT in pediatric
SBS.
Keywords
short bowel syndrome - intestinal lengthening - reconstructive surgery
