Introduction: The short bowel syndrome (SBS) associated with intestinal failure (IF) is defined as a state of transient intestinal insufficiency characterized by abundant losses by enterostomy that lead to nutritional, hydroelectrolytic and metabolic alterations. In Peru, it is mainly produced by intestinal ischemia and postoperative complications.
In surgical management it has been tried to recover the largest amount of intestine, however, anastomosis has been avoided very close to the ileocecal valve (ICV) adducing greater risk of dehiscence due to high intraluminal pressure and little vascularity.
A series of patients with anastomosis less than 10 cm from the ICV are analyzed in the present study.
Patient materials and methods: Series of cases of patients older than 18 years with a diagnosis of SBS associated with IF; with ileal jejunal anastomosis less than 10 cm from the ICV. Where a standard protocol was implemented.
Between 2011 and 2018, 120 patients with a diagnosis of SBS associated with IF were treated. We performed 52 surgeries of autologous gastrointestinal restitution (AGIR). In 11 of them, an ileal jejunal anastomosis was performed less than 10 cm from the ICV and 5 of them were made to the same ICV.
We did not find anastomosis dehiscence and 2 complications occurred: a hemoperitoneum reoperated at PO1 for hemostasis and an inadvertent lesion reoperated at PO2 to perform raffia. After the AGIR there were 7 patients with more than 1 meter of residual intestinal length (170 cm average) and 4 patients with less than 1 meter of residual intestinal length (69 cm average); the Nutrition Parenteral was administered 21 and 35 days on average respectively; and the autonomy for the oral diet was given at 3 to 5 weeks.
Conclusion: The AGIR in IF associated with SBS with anastomosis very close to the ICV are safe if they are performed with regulated techniques.