Repeated Mechanical Lengthening of Intestinal Segments in a Novel Model
Repeated Mechanical Lengthening of Intestinal Segments in a Novel Model
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DOI：
10.1016/j.jpedsurg.2015.03.020
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发表时间：
2015-06-01
影响因子：
2.4
通讯作者：
Dunn, James C. Y.
中科院分区：
文献类型：
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作者：
Scott, Andrew;Sullins, Veronica F.;Dunn, James C. Y.
目的：目前，用于机械肠延长的动物模型在分析或恢复到连续性之前使用单一延长程序。在这里，我们开发了一种新的手术模型来检验重复延长肠段的可行性。方法：采用Roux-en- y型盲肢大鼠空肠吻合术。将包封的聚己内酯弹簧放入Roux肢体的1cm片段中。4周后，将第二个包封的PCL弹簧插入延长节段的1cm部分。再过4周，将反复延长的节段取出进行组织学分析。结果：Roux肢体空肠段由1.0 cm延长至2.6 +/- 0.7 cm。第二次PCL弹簧置入四周后，1.0 cm先前延长的节段增加到2.7 +/- 0.8 cm。需要更强的机械力来实现随后的再拉长。与正常空肠黏膜相比，延长和再延长的节段增加了平滑肌厚度和隐窝深度。结论：使用Roux-en-Y模型，可以成功地延长先前延长的肠段。肠段可以进行多次延长手术以达到治疗短肠综合征的临床意义上的长度。(C) 2015爱思唯尔公司版权所有。
Purpose: Currently, animal models used for mechanical intestinal lengthening utilize a single lengthening procedure prior to analysis or restoration back into continuity. Here we developed a novel surgical model to examine the feasibility of repeated lengthening of intestinal segments. Methods: A Roux-en-Y jejunojejunostomy with a blind Roux limb was created in rats. An encapsulated polycaprolactone spring was placed into a 1 cm segment of the Roux limb. After 4 weeks, a second encapsulated PCL spring was inserted into a 1 cm portion of the lengthened segment. After another 4 weeks, the repeatedly lengthened segments were retrieved for histological analyses. Results: Jejunal segments of the Roux limb were successfully lengthened from 1.0 cm to 2.6 +/- 0.7 cm. Four weeks after the second PCL spring placement, 1.0 cm of the previously lengthened segment increased to 2.7 +/- 0.8 cm. Stronger mechanical force was required to achieve subsequent re-lengthening. Lengthened and re-lengthened segments had increased smooth muscle thickness and crypt depth when compared to normal jejunal mucosa. Conclusion: Using the Roux-en-Y model, previously lengthened segments of intestine can be successfully re-lengthened. Intestinal segments may be subjected to multiple lengthening procedures to achieve clinically significant length for the treatment of short bowel syndrome. (C) 2015 Elsevier Inc. All rights reserved.