J Pediatr Surg. 2022 Jan;57(1):117-121. doi: 10.1016/j.jpedsurg.2021.09.028. Epub 2021 Sep 20.

Francesca Bell Peters ¹, Jeffrey N Bone ², Rhonda Van Oerle ³, Susan Albersheim ³, Linda Casey ⁴, Hannah Piper ⁵

Author information

¹Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T1Z3, Canada. Electronic address: fbellpeters@gmail.com.

²BC Children's Hospital Research Institute, Vancouver, BC, Canada.

³Division of Neonatology, University of British Columbia/BC Women's Hospital and Health Center, Vancouver, BC, Canada.

⁴Department of Pediatrics, University of British Columbia/BC Children's Hospital, Vancouver, BC, Canada.

⁵Division of Pediatric Surgery, University of British Columbia/BC Children's Hospital, Vancouver, BC, Canada. Electronic address: Hannah.piper@cw.bc.ca.

Abstract

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.