The First Report of the International STEP Data Registry: Indications, Efficacy and Complications A

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The First Report of the International STEP Data
Registry Indications, Efficacy and Complications
A Good First Step

• Biren P. Modi MD, Patrick J. Javid MD, Tom Jaksic
  MD PhD, Hannah Piper MD, Monica Langer MD, and
  Heung Bae Kim MD
• on behalf of
• The International STEP Data Registry
• May 23, 2006

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Serial Transverse Enteroplasty (STEP)

• Introduced in 2003 for intestinal lengthening and
  tapering in Short Bowel Syndrome
• No single center is likely to obtain sufficient
  experience
• Multicenter analysis needed

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www.STEPoperation.org
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Demographics

• 38 patients have been enrolled through April,
  2006
• Mean age at STEP 5.4 years (range DOL1 to 19.9
  years)
• Median Follow-up 11.5 months
• 19 pediatric surgery groups have submitted
  patients

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Outcomes
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Outcomes
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Complications
All mortality occurred from complications of
liver failure after referral for transplant
Total n38
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Conclusions

• STEP has been performed successfully and safely
  around the world
• The indications for the procedure have broadened
  to include SBS, bacterial overgrowth and neonatal
  atresia
• STEP is effective in bowel lengthening,
  increasing enteral tolerance and treating
  persistent refractory bacterial overgrowth
• The complication profile of the STEP procedure is
  highly favorable

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Conclusions

• Data provided by the Registry has helped to
  improve the operative technique and define the
  indications and outcomes of the STEP procedure
• With continued accrual, the goal of the
  International STEP Data Registry is to assist in
  the process of patient selection and patient
  counseling

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International STEP Data Registry-Participating
Groups

• Austin Pediatric Surgery Association
• Baylor College of Medicine
• Childrens Hospital Boston
• Childrens Hospital of Michigan
• Childrens Hospital of New Jersey
• Childrens Hospital of New York
• Columbus Childrens Hospital
• C.S. Mott Childrens Hospital, University of
  Michigan
• Hospital S Joao (Portugal)

• Hospital Universitario Valle de Hebron (Spain)
• Kapiolani Pediatric Surgery
• Northwest Permanente
• Pediatric Surgery of Idaho
• Pediatric Surgical Associates, Minneapolis
• Penn State University
• Schneider Childrens Hospital
• Seattle Childrens Hospital
• University of Utah
• Vanderbilt Childrens Hospital

www.STEPoperation.org