Multimodal Surgical Approach for Adult Patients With Chronic Intestinal Pseudo-Obstruction: Clinical and Psychosocial Long-term Outcomes

Transplant Proc. 2018 Jan-Feb;50(1):226-233. doi: 10.1016/j.transproceed.2017.11.012.

Abstract

Background: Clinical and psychosocial outcomes of a multimodal surgical approach for chronic intestinal pseudo-obstruction were analyzed in 24 patients who were followed over a 2- to 12-year period in a single center after surgery or intestinal/multivisceral transplant (CTx).

Methods: The main reasons for surgery were sub-occlusion in surgery and parenteral nutrition-related irreversible complications with chronic intestinal failure in CTx.

Results: At the end of follow-up (February 2015), 45.5% of CTx patients were alive: after transplantation, improvement in intestinal function was observed including a tendency toward recovery of oral diet (81.8%) with reduced parenteral nutrition support (36.4%) in the face of significant mortality rates and financial costs (mean, 202.000 euros), frequent hospitalization (mean, 8.8/re-admissions/patient), as well as limited effects on pain or physical wellness.

Conclusions: Through psychological tests, transplant recipients perceived a significant improvement of mental health and emotional state, showing that emotional factors were more affected than were functional/cognitive impairment and social interaction.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Chronic Disease
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Intestinal Diseases / etiology
  • Intestinal Diseases / psychology
  • Intestinal Diseases / surgery*
  • Intestinal Pseudo-Obstruction / psychology
  • Intestinal Pseudo-Obstruction / surgery*
  • Intestines / transplantation*
  • Male
  • Middle Aged
  • Parenteral Nutrition, Total / adverse effects
  • Postoperative Period
  • Quality of Life / psychology*
  • Retrospective Studies
  • Treatment Outcome
  • Viscera / transplantation*
  • Young Adult