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. 2022 Aug;74(4):1209-1223.
doi: 10.1007/s13304-022-01316-3. Epub 2022 Jul 8.

Serial transverse enteroplasty (STEP) in case of short bowel syndrome: did we achieve our goal? A systematic review

A Lauro  1 , A Santoro  2 , R Cirocchi  3 , M Michelini  3 , N Zorzetti  4 , M C Cianci  5 , M I Bellini  6 , C Casadei  7 , M C Ripoli  8 , R Coletta  5 , S Khouzam  9 , I R Marino  9 , V D'Andrea  2 , A Morabito  5
Affiliations

Serial transverse enteroplasty (STEP) in case of short bowel syndrome: did we achieve our goal? A systematic review

A Lauro et al. Updates Surg. 2022 Aug.

Abstract

Surveys on Serial Transverse Enteroplasty (STEP) published in international literature (1 January 2003- 31 May 2021) were searched. Articles were included from 17 countries: 1/23 comparative and 22/23 cohort studies. STEP was performed on 308 patients: pediatrics, adults, and mixed ages. Pediatric group included 16 studies and the adult 6. Pre-STEP residual small bowell (SB) length for pediatrics and adults ranged from 18 to 26 cm and from 30 to 70 cm, respectively. Post-STEP increased SB length for pediatrics and adults ranged between 42 and 100% and 50% and 176%, respectively. For pediatrics, enteral autonomy was reached in 32.22% of cases, parenteral nutrition (PN) dependence was 36.11%, a repeated STEP procedure (Re-STEP) was needed in 17.22%, and a bowel transplant was performed in 6.11%. In adults, enteral autonomy was achieved in 52.38%, while PN dependence was 37.1%, and no Re-STEP or transplantation were required. For the mixed group, post-STEP bowel length increased from 2 to 50 cm, enteral autonomy was obtained in 43%, PN dependence was 57%, without reported Re-STEP or transplantation. Mortality rates were between 5.55% (pediatric) and 7.14% (adults). Preoperative length with preservation of ileocecal valve represented the main predictive factors to achieve enteral autonomy.

Keywords: Serial transverse enteroplasty; Short bowel syndrome; Small bowel surgery; Systematic review.

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