[Extensive small bowel resections].

Abstract

Bowel resections of at least 70% of the total length give rise to nutritional and metabolic disorders. The consequences are also related to the site of the resection itself, to the causative disease and thus to the patient's morphological and functional adaptation capacity. Over the past 20 years we have operated on 32 patients for vascular disorders, Crohn's disease, intestinal volvulus, actinic enteritis, and ileo-caecal carcinoma. In all patients total parenteral nutrition was started and followed by enteral nutrition and oral feeding after variable periods of time. The postoperative course, in terms of adaptation and stabilisation, was regular on most cases: only in the patients operated on for Crohn's disease was symptom and nutritional remission belated or incomplete. The perioperative mortality was 34% (11 patients). The extent of the resection was often conditioned by the topography of irreversible anatomico-pathological lesions and only in one case did a colic resection prove necessary. In more extensive resections, involving a longer adaptation time, enteral nutrition was supplemented with total parenteral nutrition for lengthier periods.