Colorectal surgery for intestinal failure within national highly specialized care: early outcomes from Sahlgrenska University Hospital
Anna Persson, Johan Tranberg, Lars Börjesson, Jan Brun, Jonas Varkey, Jonas Bengtsson, Maria HermansonAbstract
Introduction
Intestinal failure (IF) requires parenteral support and is associated with reduced quality of life and significant morbidity. Since January 2024, care for adult IF patients has been centralized as National Highly Specialized Care (NHV) in Sweden. Reconstructive surgery may restore intestinal continuity and reduce dependence on parenteral nutrition, but data on outcomes are limited.
Methods
All consecutive patients undergoing colorectal surgery for IF within the NHV programme at Sahlgrenska University Hospital were included. Demographics, aetiology, operative details, complications, reoperations, and parenteral support at follow-up were analysed.
Results
Twenty patients were included (12 female), median ASA grade 2 (1–4). The most common cause of IF was surgical complications (n = 16), followed by malignancy (n = 2), Crohn's disease (n = 1) and radiation injury (n = 1). All patients required parenteral support preoperatively. Median operative time was 309 (64–519) minutes. Reoperation within 30 days occurred in four patients. Four patients were readmitted within 30 days. At 90 days, 13 of 20 (65%) patients were independent of parenteral nutrition. At one year, 8 of 10 (80%) patients remained free from parenteral nutrition. No mortality was observed.
Discussion
Early experience of colorectal surgery for IF within NHV demonstrates acceptable safety and a high rate of independence from parenteral nutrition. Centralized, specialized surgical management may play a key role in the treatment of intestinal failure.