Innovative technologies in the treatment of short bowel syndrome

Abstract

Introdiction. In recent years, many new technologies for the management of patients with short bowel syndrom (SBS), including SBS-IF (short bowel syndrom with intestinal failor), have appeared. The implemented surgical techniques are aimed at slowing down the progress of intestinal contents (antiperistaltic inserts, the creation of artificial valves in the small intestine, loops or pockets from the small intestine, etc.); surgical elongation of the small intestine (the most common STEP, Bianchy technique); intestinal transplantation. At the same time, when the intestine is shortened to 1.5–2,0 m, the adaptive rearrangements are still able to provide (albeit suppressed), but partially preserved absorption processes (in 80% of cases, the surface of the intestine is sufficient for slow transport of nutrients from the intestine to the blood). Therefore, it is important to increase the efficiency of adaptive rearrangements in any conservative way shown.Аim. Тo evaluate the role of hormonal stimulation of adaptive rearrangements in the residual bowel stump.Materials and methods. Рarameters of the well-known alimentary-volemic diagnosis, assessment of adaptive changes in the gastrointestinal tract (performed by determining citruline and GLP-2, as well as by morphological method). To stimulate the regulation of adaptive processes, a hormone preparation GLP-2 (teduglutide) was used in the nutritional support program.Results. It was shown that the length of the intestinal stump up to 1.5–2.0 m allows for digestive and transport processes due to adaptive rearrangements of the intestinal epithelium. With a super-short intestine, it is advisable to choose surgical methods of correction.Conclusion. For conservative correction of adaptive processes in the intestine, it is advisable to use a GLP-2 hormone preparation, in particular, teduglutide.