{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:37:59Z","timestamp":1760920679852,"version":"build-2065373602"},"reference-count":9,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,7,20]],"date-time":"2018-07-20T00:00:00Z","timestamp":1532044800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Intestinal autotransplantation (IATx) and ex vivo resection is a novel surgical strategy to treat patients with unresectable abdominal neoplasms involving the mesenteric root. Nutritional challenges after IATx and ex vivo surgery have not been well described.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eleven patients, aged 7\u201368 years (median, 49 years) underwent IATx and ex vivo resection at our center from 2009 to 2016. A retrospective chart review was performed to evaluate nutrition status, tolerance of an oral diet, and need for parenteral nutrition (PN) and enteral (EN) nutrition. These factors were assessed preoperatively and at 3 months postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Prior to surgery, 10 of 11 patients were tolerating oral diets without need for additional PN or EN. Postoperatively, PN was initiated in all patients from 1\u201315 days after surgery (median, 5 days) and continued from 12\u2013122 days (median, 32.5 days), except for of 1 patient who underwent a total enterectomy and required subsequent allotransplantation with ongoing PN. EN was initiated in 9 patients from 4\u2013117 days after surgery (median, 17\u00a0days) and has been ongoing in 5 patients. Oral diets were initiated in all patients from 5\u2013115 days (median, 14 days) postoperatively; at 3 months, 11 of 12 patients were tolerating oral diets.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>IATx and ex vivo resection presents a unique challenge with respect to nutrition management. Patients undergoing these complex surgeries may have difficulty maintaining adequate nutrition with an oral diet alone in the immediate postoperative period and beyond and may require prolonged nutrition support.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpen.1415","type":"journal-article","created":{"date-parts":[[2018,7,20]],"date-time":"2018-07-20T10:19:13Z","timestamp":1532081953000},"page":"245-251","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Nutritional Challenges in Patients After Intestinal Autotransplantation and Ex Vivo Surgery"],"prefix":"10.1002","volume":"43","author":[{"given":"Shilpa","family":"Ravella","sequence":"first","affiliation":[{"name":"Department of Medicine Columbia University  New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Liou","sequence":"additional","affiliation":[{"name":"Department of Surgery Columbia University  New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Velasco","sequence":"additional","affiliation":[{"name":"Department of Surgery Columbia University  New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alycea","family":"Harrison","sequence":"additional","affiliation":[{"name":"Department of Surgery Columbia University  New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoaki","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Surgery Columbia University  New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mercedes","family":"Martinez","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Columbia University  New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,7,20]]},"reference":[{"issue":"3","key":"e_1_2_8_2_1","first-page":"120","article-title":"Ex vivo resection and small bowel autotransplantation for the treatment of tumors at the root of the mesentery","volume":"5","author":"Nikeghbalian S","year":"2014","journal-title":"Int J Organ Transplantation Med"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCO.0b013e32832a2215"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0899-9007(00)00368-3"},{"issue":"7","key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1093\/ajhp\/61.7.671","article-title":"Nutritional support and the surgical patient","volume":"61","author":"Huckleberry Y","year":"2004","journal-title":"Am J Health Syst Pharm"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0261-5614(02)00215-7"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199302000-00013"},{"key":"e_1_2_8_8_1","first-page":"18","article-title":"Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients","volume":"26","author":"A.S.P.E.N. 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