OBJECTIVE
For the first time, we aimed to report experiences with an intestinal rehabilitation unit (IRU) from a country without home parenteral nutrition (HPN).
METHODS
We included all patients with a diagnosis of intestinal failure (IF) since the establishment of our IRU from February 2018 to February 2020. We further report on our protocols for management of enterocutaneous fistulas (ECF), short bowel syndrome (SBS), chronic intestinal pseudo-obstruction and motility disorders.
RESULTS
Among a total of 349 patients who have been admitted, 100 patients had IF and were included in this report. Mean (SD) age of patient was 46.3±16.1 years. Most common cause of IF was ECF (32%), SBS (24%), and SBS+fistula (22%). Most common causes of SBS were mesenteric ischemia (63.3%) and repeated surgery (22.4%). Median (IQR) duration of parenteral nutrition (PN) for patients was 3218-60 days. The most common reconstructive surgery performed was resection and anastomosis (75.4%), followed by serial transverse enteroplasty procedure (STEP) (10.5%) and closure of ostoma (7%). Patients were hospitalized for a median (IQR) of 33 (17.5-61) days. Most common complications were sepsis (45%), catheter infections (43%), and catheter thrombosis (20%), respectively. At final follow-up, 61% became off PN, 23% became candidates for transplantation and 16% died.
CONCLUSION
Considering that most countries lack facilities for HPN, by establishing IRUs and multidisciplinary teams, using specific treatment protocols and autologous gastrointestinal reconstruction techniques will provide a means to manage patients with IF, decreasing death rates and number of patients who require intestinal transplantations due to IF. This article is protected by copyright. All rights reserved.