J.Jpn. Surg. Soc.. 89(9): 1391-1394, 1988
Report on the annual meeting
PROBLEMS AND DIFFICULTIES IN ADAPTING PERIOD IN INFANTS AND
CHILDREN RECEIVED MASSIVE INTESTINAL RESECTION
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Department of Pediatric Surgery, Juntendo University School of Medicine, Tokyo, Japan Shiro Hasegawa, Yoshinori Hirai, Yutaka Sanada, Toshiyuki Nakagawa, Yasuo Yoshizawa, Teruaki Amagai, Takeshi Miyano |
This study was done in 17 survivals of 31 infants and children received massive intestinal resection (residual intestine; less than 75cm) between 1966－1987 to define these problems and difliculties.
1) Postoperative hepatic dysfunction occurred in 11 of the 17 survivals. The relationship between relapsing frequency of hepatic dyefunction and length of remaining ileal segment suggested that the reduced ileal length may be one of the etiologic factors of the hepatic dysfunction.
2) Evaluation of serum bile acid levels suggested that the disturbance of bile acid reabsorption and its rapid tum over might still remain even after catch-up growth of these patients.
3) Abnormal levels of serum minerals(Ca, InP, Mg, Zn and Cu)were observed in 4 cases during TPN, and these abnormalities disappeared by discontinuation of parenteral nutrition and biginning of oral feeding.
4) Serum vitamin levels (Vit.A, Vit.E, 25-OH-D3, and Vit.B12) still remained in abnomal even after the patients reached school age.
These results suggested that very long-term nutritional cares, especially in lipid and vitamin nutrition, are necessary for the children with massive intestinal resection.
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