Abstract

Background & Aims

The intestinal rehabilitation program (IRP) is a specialized approach to managing patients with intestinal failure (IF). The goal of IRP is to reduce the patient’s dependence on parenteral nutrition by optimizing nutrition intake while minimizing the risk of complications and providing individualized medical and surgical treatment. We aimed to provide a thorough overview of our extensive history in adult IRP.

Methods

We reviewed the medical records of adults with IF treated at our center’s IRP over the past two decades. We collected data on demographic and clinical results, such as the causes of IF, the current status of the remaining bowel, nutritional support, and complications or mortality related to IF or prolonged parenteral nutrition.

Results

We analyzed a total of 47 adult patients with a median follow-up of 6.7 years. The most common cause of IF was massive bowel resection due to mesenteric vessel thrombosis (38.3%). Twenty-eight patients underwent rehabilitative surgery, including 12 intestinal transplants. The 5-year survival rate was 81.9% with 13 patients who expired due to sepsis, liver failure, or complication after transplantation. Of the remaining 34 patients, 18 were successfully weaned off from parenteral nutrition.

Conclusion

Our results of IRP over two decades suggest that the individualized and multidisciplinary program for adult IF is a promising approach for improving patient outcomes and achieving nutritional autonomy.

中文翻译：

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成人肠衰竭患者的肠道康复计划：三级医院单中心经验 20 年结果分析

摘要

背景与目标

肠道康复计划 (IRP) 是治疗肠道衰竭 (IF) 患者的专门方法。IRP 的目标是通过优化营养摄入，同时最大限度地降低并发症风险并提供个体化的医疗和手术治疗，减少患者对肠外营养的依赖。我们的目的是全面概述我们在成人 IRP 方面的丰富历史。

方法

我们回顾了过去 20 年来在我们中心的 IRP 接受治疗的 IF 成人患者的医疗记录。我们收集了人口统计学和临床​​结果的数据，例如 IF 的原因、剩余肠道的当前状态、营养支持以及与 IF 或长期肠外营养相关的并发症或死亡率。

结果

我们总共分析了 47 名成年患者，中位随访时间为 6.7 年。IF最常见的原因是肠系膜血管血栓形成导致的大肠切除（38.3%）。28 名患者接受了康复手术，其中 12 名患者接受了肠道移植手术。5年生存率为81.9%，其中13名患者因脓毒症、肝功能衰竭或移植后并发症而死亡。其余 34 名患者中，18 名成功戒断肠外营养。

结论

我们二十年来的 IRP 结果表明，针对成人 IF 的个性化和多学​​科计划是改善患者预后和实现营养自主的一种有前途的方法。