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Assessment and management of patients with intestinal failure: a multidisciplinary approach

Authors Grainger JT, Maeda Y, Donnelly SC, Vaizey CJ

Received 29 September 2017

Accepted for publication 22 March 2018

Published 12 June 2018 Volume 2018:11 Pages 233—241


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Ms Justinn Cochran

Peer reviewer comments 3

Editor who approved publication: Prof. Dr. Everson L.A. Artifon

Jennie T Grainger,1 Yasuko Maeda,1,2 Suzanne C Donnelly,1 Carolynne J Vaizey1,2

1The Lennard Jones Intestinal Failure Unit, St. Mark’s Hospital, Harrow, UK; 2Faculty of Medicine, Imperial College London, London, UK

Abstract: Intestinal failure (IF) is a condition characterized by the inability to maintain a state of adequate nutrition, or fluid and electrolyte balance due to an anatomical or a physiological disorder of the gastrointestinal system. IF can be an extremely debilitating condition, significantly affecting the quality of life of those affected. The surgical management of patients with acute and chronic IF requires a specialist team who has the expertise in terms of technical challenges and decision-making. A dedicated IF unit will have the expertise in patient selection for surgery, investigative workup and planning, operative risk assessment with relevant anesthetic expertise, and a multidisciplinary team with support such as nutritional expertise and interventional radiology. This article covers the details of IF management, including the classification of IF, etiology, prevention of IF, and initial management of IF, focusing on sepsis treatment and nutritional support. It also covers the surgical aspects of IF such as intestinal reconstruction, abdominal wall reconstruction, and intestinal transplantation.

Keywords: intestinal failure, short bowel syndrome, nutrition, abdominal wall reconstruction, multidisciplinary approach, enterocutaneous fistula

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