Multimodal Surgical Approach for Adult Patients With Chronic Intestinal Pseudo-Obstruction: Clinical and Psychosocial Long-term Outcomes |
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Authors: | A Lauro AD Pinna E Tossani V Stanghellini M Manno G Caio L Golfieri C Zanfi N Cautero A Bagni U Volta M Di Simone L Pironi RF Cogliandro M Serra A Venturoli S Grandi R De Giorgio |
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Institution: | 1. General Surgery and Transplant Unit, Department of Medical and Surgical Sciences, “M. Miglioli” Chronic Intestinal Failure Centre, “F. Addarii” Institute of Oncology and Pathology, St. Orsola–Malpighi University Hospital–Bologna, Bologna, Italy;2. Department of Psychology, University of Bologna, Bologna, Italy;3. Transplant Unit, University Hospital of Modena, Moderna, Italy;4. Department of Clinical Sciences, S. Anna–Cona University Hospital, Ferrara, Italy |
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Abstract: | BackgroundClinical 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).MethodsThe main reasons for surgery were sub-occlusion in surgery and parenteral nutrition–related irreversible complications with chronic intestinal failure in CTx.ResultsAt 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.ConclusionsThrough 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. |
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Keywords: | Address correspondence to Augusto Lauro General Surgery and Transplant Unit St Orsola University Hospital Bologna Italy |
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