Autologous Intestinal Reconstruction: What, When, and Why?

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Abstract

Post-resection short bowel syndrome, which is manifested as a severe intestinal failure, is a pressing medical and social problem due to persistent intestinal dyspepsia and progressive, sometimes life-threatening, malnutrition in these patients, leading to their early disability and long-term dependence on parenteral nutrition and maintenance infusion therapy. The introduction of modern parenteral nutrition technologies into clinical practice, which can be successfully carried out by patients self-dependently at home, has significantly changed the quality of life and ensured relatively long survival of the patients. However, parenteral nutrition can have a number of complications (catheter-associated bloodstream infection, venous thrombosis, hepatopathy, etc.), which requires a complex of therapeutic measures aimed at achieving enteral autonomy in these patients, significantly reducing or eliminating the need for intravenous support. One of the most essential areas that contributes to the achievement of enteral autonomy in this category of patients is autologous intestinal reconstruction surgery (AIRS).

The aim of the review is to summarize and systematize the accumulated current information on various options for surgical treatment of patients with post-resection short bowel syndrome and intestinal failure (SBS-IF) using various surgical techniques.

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About the authors

Sergey K. Demidov

Department No. 3 of the 1477th Naval Clinical Hospital

Author for correspondence.
Email: Demidov9696@mail.ru

Senior Lieutenant at the Medical Service, Senior Resident at the Surgical Department

Russian Federation, Vilyuchinsk, Kamchatka Territory

Ildar M. Batyrshin

Janelidze Saint Petersburg Research Institute of Emergency Medicine; Kirov Military Medical Academy

Email: onrush@mail.ru

M.D., Head of the 11th Surgical Department

Russian Federation, Saint Petersburg; Saint Petersburg

Andrey E. Demko

Janelidze Saint Petersburg Research Institute of Emergency Medicine; Kirov Military Medical Academy

Email: demkoandrey@gmail.com

M.D., Professor, Honored Doctor of the Russian Federation, Deputy Director for Scientific Work

Russian Federation, Saint Petersburg; Saint Petersburg

Valery M. Luft

Janelidze Saint Petersburg Research Institute of Emergency Medicine

Email: lvm_aspep@mail.ru

M.D., Professor, Honored Physician of the Russian Federation, Head of the Clinical Nutrition Department

Russian Federation, Saint Petersburg

Norik A. Avetyan

Janelidze Saint Petersburg Research Institute of Emergency Medicine

Email: norikavetyan@mail.ru

Surgeon at the 11th Surgical Department

Russian Federation, Saint Petersburg

Dmitry V. Fomin

Janelidze Saint Petersburg Research Institute of Emergency Medicine

Email: doctordmitryfomin@yandex.ru

Ph.D., Surgeon at the 11th Surgical Department

Russian Federation, Saint Petersburg

Yulia S. Ostroumova

Janelidze Saint Petersburg Research Institute of Emergency Medicine

Email: yulia575091@yandex.ru

Ph.D., Surgeon at the 11th Surgical Department, Researcher at the Department of Surgical Infections

Russian Federation, Saint Petersburg

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Supplementary files

Supplementary Files
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1. JATS XML
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2. Fig. 1-3. Antiperistaltic reverse segment.

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3. Fig. 4. Procedures for correction of intestinal dilation and stasis.

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4. Fig. 5. Longitudinal elongation and adaptation of the gut (LILT).

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5. Fig. 6. Serial transverse enteroplasty (STEP).

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6. Fig. 7. Spiral elongation and adaptation of the intestine (SILT).

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7. Fig. 8. Controlled intestinal expansion and extracorporeal chyme recycling.

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Copyright (c) 2025 Demidov S.K., Batyrshin I.M., Demko A.E., Luft V.M., Avetyan N.A., Fomin D.V., Ostroumova Y.S.

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