Outcomes of Children with Short Bowel Syndrome (SBS) | Single-centre Retrospective review | 2001 - 2022 | Hong Kong | 64 children | Extensive necrotising enterocolitis (NEC) (n=43) | Median bowel length= 45 cm | 18.9% of the expected length/age | Mean follow-up period: 8.9 years | 57 patients (89%) survived | 50 (78%) weaned off parenteral nutrition (PN) | Significant predictors of mortality: | Patients managed before 2007, prior to fish oil-based PN (p = 0.001) | Presence of intestinal failure-associated liver disease (p = 0.02) | Ultrashort bowel length was not associated with significantly higher mortality (OR = 1.1, p = 0.65) | Conclusion: A multidisciplinary intestinal rehabilitation program effectively improves outcomes for SBS patients, with advancements in PN and new treatment strategies enhancing survival and enteral autonomy. | https://pubmed.ncbi.nlm.nih.gov/39147684/ | Tsang JT et al. | Department of Surgery, School of Clinical Medicine, University of Hong Kong, Hong Kong | @EmGooteeMD | @StayCurrentMD | Journal of Pediatric Surgery
Outcomes of Children With Short Bowel Syndrome: Experiences in a Multidisciplinary Intestinal Rehabilitation Unit Over Two Decades
Infographic · Mar 2025 · 1 min read
In brief
In brief
This 20-year retrospective study of 64 pediatric SBS patients demonstrates 89% survival and 78% PN weaning rates through multidisciplinary intestinal rehabilitation. Fish oil-based PN introduction in 2007 significantly improved outcomes, while IFALD and pre-2007 management predicted mortality. Ultrashort bowel length impaired PN weaning but not survival.
- 78% of pediatric SBS patients achieved enteral autonomy over mean 8.9-year follow-up with multidisciplinary intestinal rehabilitation
- Fish oil-based PN introduced in 2007 significantly reduced mortality risk (OR=5.9) compared to earlier lipid formulations
- IFALD presence increased mortality risk 6-fold; early recognition and lipid management are critical in SBS care
- Ultrashort bowel length predicted PN dependence (OR=3.57) but not mortality, supporting aggressive rehabilitation efforts
- 89% survival rate demonstrates effectiveness of comprehensive intestinal rehabilitation programs for pediatric SBS management
Written by the GCMD Library team from the infographic.
The infographic uses a teal, gray, and yellow color scheme with illustrations of a baby and fish. The layout is divided into sections with the title at top, patient cohort details in the middle showing a map of Hong Kong, key statistics with bullet points, and a yellow conclusion banner at bottom. Visual elements include an anatomical heart illustration on the baby figure and decorative fish graphics.
Jaime Tsz-Wing Tsang, Adrian Chi-Heng Fung, Stephen Cheuk-Lam Lau, Kenneth Kak-Yuen Wong
Background: Short bowel syndrome (SBS) is a rare but serious form of organ failure, and patients with SBS depend on total parenteral nutrition (PN) to maintain growth and development. The present study aimed to evaluate the experiences and outcomes of children with SBS managed by a multidisciplinary intestinal rehabilitation programme in a tertiary paediatric centre.
Methods: A retrospective single-centre analysis of all paediatric patients with a clinical diagnosis of SBS between 2001 and 2022 was performed. Clinical outcomes and their predictors were extracted and analysed.
Results: Of the 64 children included in the study, 43 (67%) had extensive necrotising enterocolitis. The median bowel length was 45 cm (interquartile range (IQR) = 18-65) and 18.9% (IQR = 10-28.5) of the expected length based on age. Over a mean follow-up period of 8.9 years, 57 patients (89%) survived, and 50 (78%) weaned off PN. The presence of intestinal failure-associated liver disease (IFALD) (OR = 6.375, p = 0.02) and patients managed before the introduction of fish oil-based PN in 2007 (OR = 5.895, p = 0.001) were significant predictors of mortality. There was an overall improvement in survival over time (p = 0.003). Ultrashort bowel length was not associated with significantly higher mortality (OR = 1.1, p = 0.65) but was a poor prognostic factor for weaning off PN (OR = 3.57, p = 0.004). Among all patients who weaned off PN, two had bowel lengthening procedures and one received a glucagon-like peptide 2 (GLP-2) analogue.
Conclusions: A multidisciplinary intestinal rehabilitation programme offers a comprehensive approach for patients with SBS and has been shown to be effective with favourable outcomes. Improvements in the choice of PN and the development of new treatment strategies potentially improved the survival and enteral autonomy of SBS patients.