PD311 - INTESTINAL SURGERY WITH SERIAL TRANSVERSE ENTEROPLASTY (STEP) IMPROVES OUTCOMES IN ADULTS WITH SHORT BOWEL SYNDROME

PD311

INTESTINAL SURGERY WITH SERIAL TRANSVERSE ENTEROPLASTY (STEP) IMPROVES OUTCOMES IN ADULTS WITH SHORT BOWEL SYNDROME

Y. Li^1,*, L. Zheng¹, D. Yao¹, Y. Huang¹, Z. Zhou¹

¹Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

Rationale: Serial transverse enteroplasty (STEP) is an established bowel-lengthening strategy in pediatric short-bowel syndrome (SBS), but its efficacy in adults, particularly when combined with simultaneous intestinal repair, remains unclear.

Methods: We retrospectively analyzed consecutive adult SBS patients undergoing a single-stage open procedure combining definitive repair with immediate STEP. Inclusion required persistent parenteral nutrition (PN) dependence (≥180 days post-event despite maximal medical therapy) and bowel dilatation suitable for a 45-mm stapler. The primary outcome was the proportion of caloric needs met by enteral nutrition (%EN). Secondary outcome included health-related quality of life (HRQoL; SF-36), PN volume, liver function, and nutritional indices. Longitudinal %EN changes were modeled by linear mixed-effects analysis.

Results: The enteral nutrition (EN) contribution increased from a mean of 34% at baseline (median 42%) to 78% at the last review (≤12 months), with a mixed-effects slope of +0.50% per week. Parenteral nutrition (PN) volume decreased by a median 850 mL/day (IQR 700–1050), and 7/13 (53.9%) patients discontinued PN within 12 months. The SF-36 global score improved from 60.5 ± 7.4 pre-operatively to 70.2 ± 5.9 at 3 months and 78.4 ± 6.1 at 6 months (linear trend p < 0.001).

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Conclusion: Combined STEP and intestinal repair in carefully selected adults with SBS is technically feasible, safe, and achieves clinically meaningful gains in EN tolerance and quality of life. Multicenter trials are needed to confirm long-term outcomes.

Disclosure of Interest: None declared