Paediatric Session
AB021. SOH24AB_125. Outcomes of children with intestinal failure secondary to gastrointestinal dysmotility
Johann-Christoph Licht1,2, Christina Belza2,3, Yaron Avitzur2,3,4, Paul Wales5
1School of Medicine, University of Limerick, Castletroy, Limerick, Ireland;
2Research Institute, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada;
3Group for Improvement of Intestinal Function and Treatment (GIFT), The Hospital for Sick Children, Toronto, ON, Canada;
4Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, Toronto, ON, Canada;
5Cincinnati Children’s Hospital, Medical Center & The University of Cincinnati, Cincinnati, OH, USA
Background: The primary objective of our study is to determine the characteristics and outcomes of pediatric patients with intestinal failure (IF) secondary to dysmotility.
Methods: This is a retrospective cohort study of all patients managed by a multidisciplinary intestinal rehabilitation program with a diagnosis of IF with gastrointestinal (GI) dysmotility between January 1, 2006 and December 31, 2020 with a minimum one year follow up. Student’s t-test, Wilcoxon rank sum test, and X2 were used where appropriate.
Results: Fifty-one patients with intestinal dysmotility [median gestational age of 35 weeks, interquartile range (IQR): 31–37 weeks; 22 males (43%)] were studied. Median birthweight was 2,160 g (IQR: 1,635–2,586 g). Eighty-eight percent achieved enteral autonomy (EA) after a median parenteral nutrition duration of 150.5 days (IQR: 93.0–206.0 days). Advanced liver disease [conjugated bilirubin (cBili) >100 μmol/L] was seen in 2/51 patients (3.9%), with no patients receiving an intestinal or liver transplant. The case fatality rate was 3/51 (5.9%) but was related to complications of prematurity. Median follow up was 747 days (IQR: 420.5–1,691.5 days). Patients with a congenital short bowel syndrome (SBS) diagnosis (i.e., gastroschisis, necrotizing enterocolitis) had an earlier referral age [75 (IQR: 48–109) vs. 868 (IQR: 61–1,286) days] and were more likely to achieve EA (97% vs. 64%, P<0.01) compared to those with primary dysmotility (i.e., chronic intestinal pseudo-obstruction).
Conclusions: This cohort study demonstrates significant long-term survival for patients with dysmotility. There were two distinct populations-neonates with a congenital SBS diagnosis and those presenting later with a primary dysmotility. Patients with a congenital diagnosis had transient symptoms and were likely to achieve EA by 6 months.
Keywords: Gastrointestinal dysmotility in children (GI dysmotility in children); intestinal failure (IF); pediatric general surgery; congenital short bowel syndrome (congenital SBS); enteral autonomy (EA)
Acknowledgments
Funding: None.
Conflicts of Interest: The authors have no conflicts of interest to declare.
Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
doi: 10.21037/map-24-ab021
Cite this abstract as: Licht JC, Belza C, Avitzur Y, Wales P. AB021. SOH24AB_125. Outcomes of children with intestinal failure secondary to gastrointestinal dysmotility. Mesentery Peritoneum 2024;8:AB021.
