Internal plication for spring confinement to lengthen intestine in a porcine model.
Internal plication for spring confinement to lengthen intestine in a porcine model.
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DOI：
10.1371/journal.pone.0274612
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
短肠综合征及其导致的营养缺乏是肠衰竭最常见的原因。在猪模型中使用体外应用技术，使用腔内弹簧进行明显的肠道延长是可行的。我们假设，内扩技术将产生显著的肠道延长，这可能导致未来的内镜弹簧放置。未压缩的7.5厘米直径为1.0厘米的弹簧被压缩到2.0厘米。将明胶包裹的压缩镍钛诺弹簧插入幼猪空肠管腔，并在含有弹簧的节段的近端和远端用腔内缝合线固定。在弹簧的远端标记一个控制段。术后第7天对猪实施安乐死。收集弹簧和控制段进行分析。与对照组相比，弹簧段平均延长了72%。7个弹簧中有2个保持在两组应用程序中，并且长度增加了一倍。组织学显示，与对照组相比，弹簧节的粘膜完整性正常，肌肉厚度相似，但隐窝深度和绒毛长度增加。内扩张导致肠明显延长。五个弹簧滑过近端、远端或两组应用，导致比固定的延长更少。需要一种更一致的腔内缝合方法来增加长度。
Short bowel syndrome and its resultant nutritional deficiencies are the most common cause of intestinal failure. Significant intestinal lengthening using intraluminal springs is feasible in porcine models using an external plication technique. We hypothesize that an internal plication technique will yield significant intestinal lengthening, which may lead to future endoscopic spring placement. Uncompressed springs measuring 7.5 cm with a diameter of 1.0 cm were compressed to 2.0 cm. A gelatin-encapsulated compressed nitinol spring was inserted into the jejunal lumen of juvenile pigs and held in place with endoluminal sutures just proximal and distal to the spring-containing segment. A control segment distal to the spring was marked. Pigs were euthanized on postoperative day 7. Spring and control segments were collected for analyses. There was an average lengthening by 72% of the spring segment compared to the control segment. Two out of 7 springs stayed within both sets of plications and doubled in length. Histology showed normal mucosal integrity of the spring segment and plicated areas with similar muscular thickness but increased crypt depth and villus length compared to the control segment. Internal plication resulted in significant bowel lengthening. Five springs had slipped through proximal, distal or both sets of plications, resulting in less lengthening than those that remained fixed. A more consistent methodology for endoluminal suturing is needed to produce more lengthening.
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影响因子：
2.4
作者：
Portelli KI;Park JB;Taylor JS;Thomas AL;Stelzner M;Martin MG;Dunn JCY
通讯作者：
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DOI：
10.1016/j.jmbbm.2019.103413
发表时间：
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