Carbonnel et al developed prognostic scores for predicting whether a person will be nutritionally autonomous after an extensive small bowel resection. The authors are from Hopital Saint Louis and Hopital Saint Antoine in Paris.
Outcomes associated with loss of nutritional autonomy:
(1) total parenteral nutrition
(2) death from malnutrition
Parameters:
(1) type of surgical procedure
(2) length of residual small bowel in cm
Types of surgical procedures:
(1) jejunoileal anastomoses
(2) jejunocolic anastomosis
(3) end jejunostomy
Procedure
Score
jejunoileal anastomosis
(5 * (residual small bowel in cm)) - 173
jejunocolic anastomosis
(5 * (residual small bowel in cm)) - 300
end jejunostomy
(5 * (residual small bowel in cm)) - 564
If the score is >= 0 then the patient has about 90% chance of being nutritionally autonomous in the long term..
If the score is < 0, then the patient has a 40% chance of being nutritionally autonomous in the long term.
Procedure
Critical Length
jejunoileal anastomosis
< 35 cm
jejunocolic anastomosis
< 60 cm
end jejunostomy
< 115 cm
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