Comparison of STEP and LILT Procedures in Pediatric Patients With Short Bowel Syndrome — A Systematic Review and Meta Analysis

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ID: 315794
2026
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Abstract
Abstract Background The most used intestinal lengthening methods for Short Bowel Syndrome (SBS) are the Serial Transverse Enteroplasty Procedure (STEP) and the Longitudinal Intestinal Lengthening and Tailoring (LILT; Bianchi) procedure. An updated systematic review and meta-analysis comparing these two methods is lacking. Aims We aimed to summarize and meta-analyze the current literature comparing the STEP with the LILT procedure. Methods We compared STEP versus LILT in children aged between 0 and 18 years. A systematic review of the current literature since 2003 was performed, including studies comparing STEP and LILT procedure. We searched the following databases: MEDLINE (1946 to present, via Ovid), Embase (1947 to present, via Ovid) and Cochrane Central Register of Controlled Trials (CENTRAL; 1991 to present). For risk of bias assessment, we used the ROBINS-I tool. Results We identified 5855 potential articles, excluding 2028 in de-duplication and 3794 during the title and abstract screening. We assessed 33 articles for eligibility. We finally included and extracted data from five studies. All studies reported on weaning from parenteral nutrition. LILTs lead to more effective weaning from parenteral nutrition (64.5%; 20/31) compared to STEP (43.5%; 20/46). Overall mortality was low with 5.2% (4/77) of patients and not attributable to the surgical technique chosen. Both surgical methods had a similar postoperative complication rate. Redo surgery rate was 12.9% (4/31) after LILT and 36.4% (16/44) after STEP. Conclusion Patients operated by the LILT procedure seem to have a higher chance of weaning from parenteral nutrition and a lower redo surgery rate. However, this might be attributed to a systematic bias in selecting patients for this procedure.
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Authors J Muff, L Caspar, S Holland-Cunz, J Dunn, R Vuille-Dit-Bille
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag055.011
URL
https://doi.org/10.1093/bjs/znag055.011
Keywords Keywords not found

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