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Surg Today ; 52(1): 12-21, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33464414

RESUMO

Short-bowel syndrome (SBS) is defined as a state of malabsorption after resection or loss of a major portion of the bowel due to congenital or acquired factors. This article presents an overview on the recent management of pediatric SBS. The pediatric SBS population is very heterogeneous. The incidence of SBS is estimated to be 24.5 per 100,000 live births. The nutritional, medical, and surgical therapies available require a comprehensive evaluation. Thus, multidisciplinary intestinal rehabilitation programs (IRPs) are necessary for the management of these complex patients. The key points of focus in IRP management are hepato-protective strategies to minimize intestinal failure-associated liver disease; the aggressive prevention of catheter-related bloodstream infections; strategic nutritional supply to optimize the absorption of enteral calories; and the management and prevention of small bowel bacterial overgrowth, nephrocalcinosis, and metabolic bone disease. As the survival rate of children with SBS currently exceeds 90%, the application of small bowel transplantation has been evolving. The introduction of innovative treatments, such as combined therapy of intestinotrophic hormones, including glucagon-like peptide-2, may lead to further improvements in patients' quality of life.


Assuntos
Síndrome do Intestino Curto/reabilitação , Síndrome do Intestino Curto/terapia , Fatores Etários , Doenças Ósseas Metabólicas/etiologia , Doenças Ósseas Metabólicas/prevenção & controle , Pré-Escolar , Feminino , Peptídeo 2 Semelhante ao Glucagon/uso terapêutico , Humanos , Incidência , Lactente , Recém-Nascido , Insuficiência Intestinal/etiologia , Insuficiência Intestinal/prevenção & controle , Intestino Delgado/transplante , Hepatopatias/etiologia , Hepatopatias/prevenção & controle , Masculino , Nefrocalcinose/etiologia , Nefrocalcinose/prevenção & controle , Qualidade de Vida , Síndrome do Intestino Curto/epidemiologia , Síndrome do Intestino Curto/etiologia
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