Surgical management of short bowel syndrome

RESUMO

Treatment of the short bowel syndrome (SBS) following massive resections of the small bowel, sometimes associated with colon resection, remains a difficult problem. The use of total parenteral nutrition has resulted in more patients surviving massive intestinal resection. Therefore, interest persists in surgical therapy for the SBS. The goals of surgical therapy in the SBS are to increase the area of absorption, and slow down intestinal transit. However, none of the current surgical alternatives to treat SBS are sufficiently safe and effective to be recommended as a routine procedure. To achieve specific results, surgical treatment should be considered only for selected patients. Thus, the surgical emphasis continues to be on the prevention of massive enterectomy, or on the conservation of a much of the intestine as possible when ressection is inevitable.