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2004, Number 5

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Cir Cir 2004; 72 (5)

The role of long-acting release (LAR) depot octreotide as adjuvant management of short bowel disease

Gómez-Herrera E, Farías-Llamas OA, Gutiérrez-de la Rosa JL, Hermosillo-Sandoval JM

Language: Spanish
References: 33
Page: 379-386
PDF size: 94.79 Kb.


ABSTRACT

Introduction: Short bowel syndrome (SBS) comprises sequelaes of nutrient, fluid, and weight loss that occur subsequent to greatly reduced functional surface area of small intestine. Maintenance of fluid and electrolyte homeostasis in patients with SBS is often difficult; additional intravenous (i.v.) fluid and electrolytes are often required to cover unabsorbed secretory losses. The recent development of the synthetic long-acting release (LAR) depot octapeptide analog, octreotide, has rendered somatostatin therapy a practical alternative in patients with SBS who have become entrapped in a vicious cycle with chronic dehydration, thirst, and excessive fluid or food consumption. Methods: During an 8-month period, adult patients of either sex with SBS and total parental nutrition (TPN) dependent on III adaptation intestinal phase were included in a prospective, open-label study. We used single-subject research. Patients were divided into two groups: intestinal reinstated patients, group A (n = 6), and patients with high stomal output, group B (n = 4). Octreotide depot (20 mg intramuscularly [i.m.] at 0-8 months) was administered. Baseline and post-treatment measurements of nutritional status and stool losses were analyzed. Results: Treatment with octreotide depot significantly reduced intestinal output (group A, p = 0.002, group B, p = 0.823), hospital stay, i.v. fluid and electrolyte requirements, in 80% TPN was not required. Conclusions: Octreotide depot is effective in diminishing i.v. fluid and electrolyte requirements by reducing stool losses in SBS patients. Multicenter studies with control group and larger sample size are required.


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