P4.25: Serial Transverse Enteroplasty in Children with Short Bowel Syndrome

Abstract

Introduction: Serial transverse enteroplasty (STEP) is an intestinal lengthening procedure used for short bowel syndrome (SBS) that was first introduced in 2003. This study aimed to report clinical outcomes in children who underwent the STEP procedure at our institution. Methods: STEP procedures were performed according to the guidelines of Kim et al. Since March 2008 at our hospital, five children dependent on parenteral nutrition (PN) underwent the STEP procedure. Pre- and post-STEP clinical outcomes were reviewed retrospectively. Results: Our cohort included three girls and four boys with SBS. The causes of SBS were jejunoileal atresia (2), necrotizing enterocolitis (4), and total colonic aganglionosis (1). The median age on STEP was 37months (range, 7–59). STEP procedures were performed 1.71 times/patient, three times in one patient, three patients for two times, and one times for four patients. Intestinal length was increased in all cases. There were no perioperative complications and no evidence of intestinal leak or obstruction. Three patients have been completely weaned from PN. Other three patients have remained on PN, but their PN requirement has been decreased. In one patient with total colonic aganglionosis with small bowel involvement, the PN requirement has not been changed. Conclusions: STEP is a simple bowel-lengthening procedure associated with promising early PN weaning and decrease in PN requirement. But in case of SBS caused by total colonic aganglionosis, it may not be so helpful. Further data from a multicenter registry are needed to evaluate its long-term efficacy and proper candidate.