2013 - ISBTS 2013 Symposium


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Mini-Oral Communications 2

26.355 - Recovery of Intestinal autonomy after Autologous Reconstructive Surgery in adults with severe intestinal failure

Presenter: Luis, Moulin, , Argentina
Authors: Hector Solar Muñiz1, Constanza Echevarría1, Luis Eduardo Moulin1, Pablo Farinelli1, Ana Crivelli1, Diego Ramisch1, Pablo Barros Schelotto1, Carolina Rumbo1, Gabriel Eduardo Gondolesi1

Recovery of Intestinal autonomy after Autologous Reconstructive Surgery in adults with severe intestinal failure

Hector Solar Muñiz1, Constanza Echevarría1, Luis Eduardo Moulin1, Pablo Farinelli1, Ana Crivelli1, Diego Ramisch1, Pablo Barros Schelotto1, Carolina Rumbo1, Gabriel Eduardo Gondolesi1

1Multiorgan Transplant Institute, Favaloro's Foundation University Hospital, Ciudad Autonoma de Buenos Aires, Argentina

Introduction:Autologous Intestinal Reconstruction Surgery (AIRS) allows reverting or improving Severe Intestinal Failure (SIF). Aim: to report the results of AIRS in adult patients with SIF treated in a specialized unit.  Methods:retrospective analysis of all patients with SIF treated in a single center from 3/2006 to 12/2012. Demographic data, etiology, nutritional status, nutritional support pre/post surgery, intestinal remnant anatomy, length of hospital stay and survival were analyzed. Results: 209 patients were evaluated, 125 adults (60%); 53 underwent AIRS and are included in this review. Mean age was 53,5±13,9 years; 58,5% females. Etiology: post-surgical 75,5% (19% with advanced oncological disease), ischemic 11,3%, radiation enteritis 7,5% and others 5,7%. The mean time of parenteral nutrition (PN) before surgery was 243,7 days (10–778). Mean post surgical small bowel remnant length (SBRL) was 174,4±108,3 cm; 96,2% had colon in continuity, and 71,7% ileocecal valve (ICV). Based on post surgical SBRL, patients were grouped as shown in Table 1. Mean time of PN pre and post surgery was 216,2 and 26 days respectively (p =0,0005).Pre surgical and at last visit BMI were 22,3 and 24 Kg/m2. Mean hospital length of stay was 19 (5-142) days. No patient died from AIRS complications, 6 oncological pts died due to disease progression. The 1 and 3 year survival:  93 % and 81% respectively.

Conclusions:in this SIF group, AIRS provided intestinal sufficiency in a high percentage of patients, with no early surgical mortality and high long term survival. Post surgical anatomy will define long term


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