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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
J Clin Nutr 2018;10:45-50
Published online December 31, 2018
© 2018 Korean Society for Parenteral and Enteral Nutrition.

Sojeong Yoon1, Sanghoon Lee1, Hyo Jung Park2, Hyun-Jung Kim3, Jihye Yoon2, Ja-Kyung Min4, Jeong-Meen Seo1
윤소정1, 이상훈1, 박효정2, 김현정3, 윤지혜2, 민자경4, 서정민1

1Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Departments of 2Pharmaceutical Services, 3Dietetics, and 4Nursing, Samsung Medical Center, Seoul, Korea
1성균관대학교 의과대학 삼성서울병원 외과, 삼성서울병원 2약제부, 3임상영양팀, 4간호부
Sanghoon Lee, https://orcid.org/0000-0002-5086-1461 Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea Tel: +82-2-3410-1872, Fax: +82-2-3410-0040, E-mail: sanghoone.lee@samsung.com
Received November 13, 2018; Revised November 22, 2018; Accepted November 26, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 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 : Short bowel syndrome, Intestinal rehabilitation, Parenteral nutrition, Intestinal failure-associated liver disease, Central line-associated blood stream infection

 

December 2018, 10 (2)