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Longitudinal Intestinal Lengthening

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Abstract

Longitudinal intestinal lengthening as a surgical procedure in short bowel syndrome (SBS) was first described in 1980. In this procedure a small bowel is lengthened and tailored. Longitudinal intestinal lengthening and tailoring (LILT) technique is based on anatomical peculiarity of the small intestine’s blood supply, when two leaves of the mesentery provide blood supply to each half of the circumference of the small bowel. Therefore, small bowel can be divided longitudinally in the midline into two sufficiently vascularized narrowed tubes, which then are implanted end to end in continuity of the bowel. The correct selection of patients and the timing of operation are very important for achieving good results. In performing this procedure, small bowel must be equally dilated. LILT should be avoided in first year of life and in patients with severe stages of liver disease and impaired coagulation. The surgery results in a better motility, less bacterial overgrowth, and translocation from the small bowel. Long-term survival after longitudinal intestinal lengthening in a 30-year period is 77 %, and parenteral nutrition weaning rate after longitudinal intestinal lengthening is 70 %. The method has risks of postoperative and long-term complications. Longitudinal intestinal lengthening is an effective method of treatment of patients with SBS, but it needs critical indications.

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Abbreviations

BaFT:

Barium follow-through

ICV:

Ileocecal valve

IFALD:

Intestinal failure-associated liver disease

LILT:

Longitudinal intestinal lengthening and tailoring

PDC:

Peridural catheter

PN:

Parenteral nutrition

PNALD:

Intestinal failure-associated liver disease

SBS:

Short bowel syndrome

SBTx:

Small bowel transplantation

STEP:

Serial transverse enteroplasty

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Author information

Authors and Affiliations

  1. Pediatric Surgery Department, University Hospital Mannheim, University of Heidelberg, Mannheim, Germany

    Lucas Marie Wessel & Rasul Khasanov

  2. Pediatric Surgery Department, Bashkir State Medical University, Ufa, Russia

    Rasul Khasanov

Authors
  1. Lucas Marie Wessel
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  2. Rasul Khasanov
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Corresponding author

Correspondence to Lucas Marie Wessel .

Editor information

Editors and Affiliations

  1. Children's Hospital, Helsinki University Central Hospital, HUS Helsinki, Finland

    Risto J. Rintala

  2. Children's Hospital, Helsinki University Central Hospital, HUS Helsinki, Finland

    Mikko Pakarinen

  3. Department of Pediatric Surgery, Karolinska University Hospital, Stockholm, Sweden

    Tomas Wester

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Wessel, L.M., Khasanov, R. (2016). Longitudinal Intestinal Lengthening. In: Rintala, R., Pakarinen, M., Wester, T. (eds) Current Concepts of Intestinal Failure. Springer, Cham. https://doi.org/10.1007/978-3-319-42551-1_9

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  • DOI: https://doi.org/10.1007/978-3-319-42551-1_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-42549-8

  • Online ISBN: 978-3-319-42551-1

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