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GS09
RESULTS OF SURGERY FOR INTESTINAL FAILURE
Author(s) -
Tonkin D. M.,
Tandon R.,
Vaizey C. J.,
Philips R. K. S.,
Gabe S.,
Nightingale J.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04917_9.x
Subject(s) - medicine , referral , intestinal failure , parenteral nutrition , surgery , retrospective cohort study , enterocutaneous fistula , presentation (obstetrics) , fistula , family medicine
Background: The main aims of intestinal failure (IF) surgery are to reduce the severity of IF in patients by repairing fistulae and restoring continuity in those with short gut, and to restore body image. We report on the surgical management of IF patients at a major tertiary referral institution, in order to evaluate current management practises and outcomes. Methods: Retrospective review of outcomes between July 2005 and December 2007. Results: 60 patients (36 male; median age 47 yrs) underwent 78 operations. On presentation 42 (70%) required parenteral nutrition (PN) and 34 (57%) had stomas. IF was secondary to short gut in 19 (30%) or enterocutaneous fistulae in 42 (70%). Median number of procedures before referral was 4 (1–14). Median time from last operation to our intervention was 365 days (25–3534). Median length of stay postoperatively was 16 days, and at a median follow‐up of 268 days, 54 (90%) had been discharged from surgical care. 7 (12%) required ICU care postoperatively but 30 day/inpatient mortality rates were 0%. Re‐fistulation occurred in 5 patients. 23 (56%) became independent of PN. Residual small bowel length was the only significant contributing factor identified (p = 0.007). Conclusion: Surgical management of IF is safe when performed in a dedicated unit and when time is allowed for patient optimisation.