Journal of Clinical Nutrition

The Korean Society for Parenteral and Enteral Nutrition (한국정맥경장영양학회)
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Multidisciplinary Intestinal Rehabilitation for Short Bowel Syndrome in Adults: Results in a Korean Intestinal Rehabilitation Team

성인 단장증후군 환자의 다학제 장 재활: 국내 단일 기관 다학제 장재활 클리닉의 경험

  • Yoon, Sojeong (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Sanghoon (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Park, Hyo Jung (Department of Pharmaceutical Services, Samsung Medical Center) ;
  • Kim, Hyun-Jung (Department of Dietetics, Samsung Medical Center) ;
  • Yoon, Jihye (Department of Pharmaceutical Services, Samsung Medical Center) ;
  • Min, Ja-Kyung (Department of Nursing, Samsung Medical Center) ;
  • Seo, Jeong-Meen (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 윤소정 (성균관대학교 의과대학 삼성서울병원 외과) ;
  • 이상훈 (성균관대학교 의과대학 삼성서울병원 외과) ;
  • 박효정 (삼성서울병원 약제부) ;
  • 김현정 (삼성서울병원 임상영양팀) ;
  • 윤지혜 (삼성서울병원 약제부) ;
  • 민자경 (삼성서울병원 간호부) ;
  • 서정민 (성균관대학교 의과대학 삼성서울병원 외과)
  • Received : 2018.11.13
  • Accepted : 2018.11.26
  • Published : 2018.12.31
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Abstract

Purpose: Intense multidisciplinary team effort is required for the intestinal rehabilitation of patients afflicted with the short bowel syndrome (SBS). These include enteral and parenteral nutrition (PN) support, monitoring of complications related to treatment, and considering further medical or surgical options for intestinal adaptation. Methods: In the Intestinal Rehabilitation Team (IRT) at the Samsung Medical Center, we have experienced 20 cases of adult SBS requiring multidisciplinary intestinal rehabilitation. This study is a retrospective review of the collected medical records. Results: Of the 20 subjects treated, 12 patients were male and 8 patients were female. At the time of referral to the IRT, the mean age was 51.5 years, and the mean body weight was 50.1 kg, which was 90% of the usual body weight. The diseases or operative managements preceding massive bowel resection were malignancy in 11 cases, cardiac surgery in 2 cases, trauma in 2 cases and one case, each of tuberculosis, corrosive esophagitis, atrial fibrillation, simultaneous pancreas and kidney transplantation, and perforated appendicitis. Of these, there were 14 survivals and 6 mortalities. The fatalities were attributed to progression of disease, intestinal failure-associated liver disease, and sepsis (unrelated to intestinal failure) (2 cases each). Among the 14 surviving patients, 8 patients have been weaned off PN, whereas 6 are still dependent on PN (mean PN dependence 36%). Conclusion: This paper reports the results of multidisciplinary intestinal rehabilitation of adult short bowel patients treated at the Samsung Medical Center. Further studies are required to improve survival and enteral tolerance of these patients.

Keywords

References

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