Outcomes of teduglutide treatment in short bowel syndrome associated with Crohn’s disease

Background: Small bowel syndrome is the leading cause of intestinal failure in children.Adaptation after resection improves absorption but leads to complications due to bowel dilatation.Serial transverse enteroplasty (STEP), first described in 2003, lengthens and tapers the bowel.This study describes long-term outcomes of children undergoing STEP in a single tertiary center Methods: This observational cohort study included all children who underwent STEP between January 2002 and December 2024.Data collected included demographics, intestinal length before and after STEP, and follow-up.Results: Eleven patients underwent 14 STEP procedures, with three requiring a second STEP.Gastroschisis was the most common diagnosis (10/11).Mean gestational age was 33.5 weeks (range 30-38), and mean birth weight was 2247g (range 1850-2950).STEP was performed at a median age of 15.1 months (range 2-28.5).Pre-STEP small bowel length was 69.3 cm (range 22.5-106), increasing to 84.6 cm (range 29-190) post-STEP (p=0.00047).Three patients died (2/3 under 6 months) at a median follow-up of 132.9 months (range 1-149).Four of nine children achieved enteral autonomy.Conclusions: STEP is feasible, reduces adaptation-related complications, and promotes bowel lengthening, positively impacting enteral autonomy.Its indication in patients under 6 months should be carefully considered.