Abstract
The utility of repeat serial transverse enteroplasty (reSTEP) has been questioned after patients failed to achieve enteral autonomy. We compared the outcomes after reSTEP to one lifetime STEP (oneSTEP), and tried to identify patients at risk for reSTEP failure. All STEPs done at our institution were reviewed. Growth, enteral autonomy, bowel-derived bloodstream infection hospital admissions, complications, and need for bowel transplantation were evaluated (p<0.05 considered significant. 24 patients underwent 32 step 16 onestep 8 restep. restep patients were younger at first surgery 1.011.05vs. onestep 3.064.73 years p=" 0.24)." median time to restep was 1.1 year 0.6-5.7. weight-for-length z-scores improved after restep 0.021.40 to 0.221.42 p=" 0.81)." bowel-derived bloodstream infections decreased after surgery onestep 1.502.25 to 0.941.73 p=" 0.50;" restep 1.882.10 to 1.662.32 p=" 0.52)." 37.5 9 24 patients achieved enteral autonomy at last follow-up: 7 16 onestep 2 8 restep p=" 0.37)." two complications occurred after onestep staple line ulcer leak none following restep. three patients onestep 1 16 restep 2 8 p=" 0.19)" underwent bowel transplantation all gastroschisis. similar postoperative outcomes after restep and single step improved enteral tolerance reduced rates of infections support the use of restep when clinically indicated although restep in young infants with a history of gastroschisis may need further evaluation.>
