*Purpose: Serial Transverse Enteroplasty Procedure (STEP) is an effective procedure to restore nutritional autonomy, but with limited experience especially in adult patients. The aims of the study are to report the largest series of STEP in adult patients with various primary disease and to develop the formula to predict discontinuation of parenteral nutrition (PN) therapy.

*Methods: Thirty-five PN dependent SGS patients (32 adults and 3 children) received STEP(s) from 2012 to 2017 at single institution. The probability of discontinuation of PN was calculated using Firth’s logistic regression model. The developed model was evaluated using a 5-fold cross validation.

*Results: Causes of short bowel syndrome included Crohn’s disease (n=4) with a mean duration of PN therapy of 21±28 months. Pre-STEP bowel length was 63±38 cm with intact ileocecal valve in 9 (23%). Bowel lengthening was accomplished with a mean increase of 43% of pre-STEP bowel length. Twenty-seven (77%) patients achieved discontinuation of PN therapy. Predictors of successful outcomes identified were post-STEP bowel length, pre-STEP PN caloric requirement, and presence of ileocecal valve. These variables were included in the probability formula (Figure). The cross validation showed that the accuracy of the formula was 0.822 with sensitivity of 0.836 and specificity of 0.781.

*Conclusions: STEP is an effective procedure for patients with extended indications in all ages. The developed formula can identify the patient who receives benefit from the procedure.

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