Purpose

Infants with short bowel syndrome (SBS) wean from parenteral nutrition (PN) support at variable rates. Small bowel length is a predictor, but the importance of the ileocecal valve (ICV) and colon are unclear. We aim to determine if the ICV and/or colon predict enteral autonomy.

Methods

Infants from a single intestinal rehabilitation program were retrospectively reviewed. Etiology of SBS, intestinal anatomy, and duration of nutritional support were collected for three years. The primary outcome was time to full enteral nutrition. ANCOVA and Cox proportional hazards model were used, with p < 0.05 significant.

Results

55 infants with SBS were included. After accounting for the effect of small bowel, PN duration was shorter for infants with the ICV compared to those without (mean 218 vs. 538 days, p = 0.003), and had a more significant effect on infants with ≤50% of small bowel. Increased small bowel length was a positive predictor of weaning. Patients with ≤50% of colon spent less time on PN with the ICV, compared to without (mean 220 vs 715 days, p = 0.009).

Conclusions

Preservation of the ICV was associated with shorter duration of PN support, while colon was not. Small bowel length is a positive predictor of enteral autonomy.

Level of Evidence

Level III retrospective comparative study

Type of Study

Retrospective review

中文翻译：

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回盲部瓣膜和结肠在短肠综合征婴儿实现肠道独立中的重要性

目的

患有短肠综合征 (SBS) 的婴儿以不同的比例从肠外营养 (PN) 支持中断奶。小肠长度是一个预测指标，但回盲部瓣膜 (ICV) 和结肠的重要性尚不清楚。我们旨在确定 ICV 和/或结肠是否预测肠内自主性。

方法

对来自单一肠道康复计划的婴儿进行了回顾性审查。收集了三年的 SBS 的病因、肠道解剖结构和营养支持的持续时间。主要结果是完全肠内营养的时间。使用 ANCOVA 和 Cox 比例风险模型，p  < 0.05 显着。

结果

包括 55 名 SBS 婴儿。在考虑到小肠的影响后，与没有 ICV 的婴儿相比，有 ICV 的婴儿的 PN 持续时间更短（平均 218 天对 538 天，p  = 0.003），并且对小肠≤50% 的婴儿有更显着的影响. 小肠长度增加是断奶的积极预测因素。与不使用 ICV 相比，结肠≤50% 的患者使用 ICV 进行 PN 的时间更少（平均 220 天 vs 715 天，p  = 0.009）。

结论

保留 ICV 与更短的 PN 支持持续时间相关，而结肠则没有。小肠长度是肠内自主性的积极预测因素。

证据水平

III级回顾性比较研究

研究类型

回顾性审查