Surgery of short bowel syndrome: Longitudinal intestinal lengthening and tailoring and serial transverse enteroplasty

The surgery of short bowel syndrome (SBS) has been designed to maximize the potential of the existing bowel and overcome the problems of proximal intestinal dilatation, impaired antegrade motility, and bacterial sumping and overgrowth. Modern surgical treatment can be said to have begun in 1980 when Adrian Bianchi designed the first effective method of bowel lengthening, now known as longitudinal intestinal lengthening and tailoring. In SBS patients without stoma, a water-soluble contrast follow-through should be completed to understand dilatation and length of residual bowel. Liver and kidney ultrasonography should be used for early detection of intestinal failure-associated liver disease and nephrocalcinosis respectively. Small bowel motility in porcine models of SBS was preserved, when compared with control animals. Nevertheless, the additional length gained after bowel-lengthening procedures should not be considered necessarily equivalent to a similar length of the native healthy bowel.