ASSESMENT OF SERIAL TRANSVERSE ENTEROPLASTY - SYSTEMATIC REVIEW
Author(s)
Yoo KJ
NECA, Seoul, South Korea
OBJECTIVES The purpose of this study was to evalute the safety and effectiveness of serial transverse enteroplasty(STEP) METHODS The clinical utility of STEP was first reviewed in three textbooks and secondly the safety and the effectiveness of the STEP were assessed based on a systematic revew. ach process. The article's quality evaluated by the SIGN's tool and the grade of recommendation were selected. RESULTS A review of the textbooks revealed that STEP is conducted on patients with refractory SBS. And the advantages of STEP are that it is technically straightforward, can form a uniform bowel channel regardless of variable underlying bowel dilation, and can be repeated if the bowel subsequently radilated. The safety of STEP was assessed based on procedure-related complications in 6 articles. The complication rate of STEP was overall 6.3~25%, bleeding 6.3~12.5%, obstruction 6.3~22%, anastomosis leak 2.3~16.7% and stricture 11~20%. The complication rate of the STEP versus the Bianchi LILT was no significantly difference. The effectiveness of STEP was assessed based on the enteral autonomy and survival rate in 9 articles.There was a trend toward a decreased rate of PN after STEP. As a result, the 33~56% patients who underwent STEP were weaned off within one year and 83~88% after one year. Survival was 83% with maximum follow-up of 68 months. CONCLUSIONS The safety of STEP was at an acceptable level as complications reported in studies generally occur after an intestinal operations and such problems can be corrected surgically.The clinical utility of STEP was described in the textbooks as a non-transplantation procedure and all the selected articles was reported on wean-off parenteral nutrition. Therefore, there is evidence for the safety and effectiveness of STEP performed on patients with refractory short bowel syndrome for promoting eneteral nutrition(Recommendation grade C).
Conference/Value in Health Info
2014-11, ISPOR Europe 2014, Amsterdam, The Netherlands
Value in Health, Vol. 17, No. 7 (November 2014)
Code
PGI53
Topic
Health Technology Assessment
Topic Subcategory
Decision & Deliberative Processes
Disease
Gastrointestinal Disorders