Staged Controlled Bowel Expansion Prior to Serial Transverse Enteroplasty in Preterm Neonates with Short Bowel Syndrome: A Safe and Feasible Strategy to Enable Intestinal Reconstruction

jpedsurg.org

Preterm neonates with short bowel syndrome represent one of the most challenging populations in pediatric intestinal rehabilitation. Autologous intestinal reconstruction is frequently delayed in this group because insufficient bowel dilation precludes safe lengthening, prolonging dependence on parenteral nutrition and increasing the risk of intestinal failure–associated liver disease, sepsis, and growth failure.

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Article · Apr 2026 · 1 min read

In brief

This article describes a novel staged approach using controlled bowel expansion to prepare preterm neonates with short bowel syndrome for serial transverse enteroplasty (STEP). The technique addresses the challenge of insufficient bowel dilation that typically delays intestinal lengthening procedures, potentially reducing complications and parenteral nutrition dependence.

Preterm neonates with short bowel syndrome often lack sufficient bowel dilation for safe intestinal lengthening procedures.
Staged controlled bowel expansion can prepare inadequately dilated bowel for serial transverse enteroplasty (STEP) in preterm infants.
Early intestinal reconstruction via this strategy may reduce parenteral nutrition dependence and associated complications.
Delayed autologous reconstruction increases risks of liver disease, sepsis, and growth failure in this vulnerable population.
This approach offers a feasible pathway to enable STEP in preterm neonates who would otherwise not be surgical candidates.

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