Generation of Porcine Ileum Through Spring-Mediated Mechanical Distraction.
Generation of Porcine Ileum Through Spring-Mediated Mechanical Distraction.
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DOI：
10.1016/j.jss.2022.07.043
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发表时间：
2022-08
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影响因子：
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通讯作者：
Modupeola Diyaolu;Anne-Laure Angele Thomas;L. Wood;J. Dunn
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作者：
Modupeola Diyaolu;Anne-Laure Angele Thomas;L. Wood;J. Dunn
简介短肠综合症是一种破坏性胃肠道疾病，肠道长度缩短导致吸收不足，从而导致营养缺乏。目前的治疗方案伴随着显着的发病率。我们提出了弹簧介导的牵引肠发生作为一种延长肠的方法，并在猪空肠中取得了成功。我们假设可以在猪回肠中证明弹簧介导的牵张肠发生，同时保留回肠结构和功能。材料和方法对幼年雌性迷你尤卡坦猪进行剖腹手术，将明胶封装的压缩镍钛诺弹簧插入回肠腔并固定在近端和远端。弹簧段远端的控制段用缝线标记。术后，对猪进行流质饮食，并在术后第 7 天实施安乐死。对弹簧和对照节段进行测量和免疫组织化学处理，以评估维生素 B12-内在因子协同转运蛋白、嗜铬粒蛋白 A 产生细胞和 5-HT 产生细胞的存在。结果所有 7 头猪均存活至术后第 7 天，没有出现不良反应。猪平均增重 84.3 ± 66.4 克/天。弹簧段延长了 1.5 ± 0.7 cm，相对延长了 128% ± 56%，与对照相比具有统计学意义（P < 0.01）。与弹簧段相比，对照中嗜铬粒蛋白-A 细胞的平均密度没有显着变化（2.9 ± 1.1 细胞/毫米与3.2 ± 1.2 细胞/毫米，P= 0.17）。维生素 B12 内在因子协同转运蛋白和 5-HT 产生细胞均存在于对照和延长的回肠中。结论 管腔内镍钛诺弹簧显着延长了猪的回肠。肠内分泌细胞密度的增加可能表明回肠延长的内分泌功能增强。
IntroductionShort bowel syndrome is a devastating gastrointestinal disorder in which decreased bowel length results in inadequate absorption causing nutritional deficiencies. Current treatment options are accompanied by significant morbidity. We have proposed spring-mediated distraction enterogenesis as a method to lengthen bowel with success seen in porcine jejunum. We hypothesize that spring-mediated distraction enterogenesis can be demonstrated in porcine ileum with preservation of ileal structure and function.Materials and methodsLaparotomy was performed on juvenile female mini-Yucatan pigs and a gelatin-encapsulated compressed nitinol spring was inserted into the ileal lumen and affixed proximally and distally. A control segment distal to the spring segment was marked with sutures. Postoperatively, pigs were placed on a liquid diet and euthanized on postoperative day 7. Spring and control segments were measured and processed for immunohistochemistry to evaluate for the presence of vitamin B12–intrinsic factor cotransporter, chromogranin A-producing cells, and 5-HT producing cells.ResultsAll seven pigs survived to postoperative day 7 with no adverse effects. On average, pigs gained 84.3 ± 66.4 g/d. Spring segments lengthened 1.5 ± 0.7 cm with a relative lengthening by 128% ± 56%, which was statistically significant when compared to control (P< 0.01). The average density of chromogranin-A cells in control compared to spring segments was not significantly changed (2.9 ± 1.1 cells/mmversus3.2 ± 1.2 cells/mm,P= 0.17). Both vitamin B12–intrinsic factor cotransporter and 5-HT producing cells were present in both control and lengthened ileum.ConclusionsIntraluminal nitinol springs significantly lengthened porcine ileum. The increase in density of enteroendocrine cells may indicate enhanced endocrine function of the lengthened ileum.