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Serial Transverse Enteroplasty Enhances Intestinal Function In a Model of Short Bowel Syndrome

Authors
 Robert W. Chang  ;  Patrick J. Javid  ;  Jung-Tak Oh  ;  Steven Andreoli  ;  Heung Bae Kim  ;  Dario Fauza  ;  Tom Jaksic 
Citation
 ANNALS OF SURGERY, Vol.243(2) : 223-228, 2006 
Journal Title
ANNALS OF SURGERY
ISSN
 0003-4932 
Issue Date
2006
MeSH
Anastomosis, Surgical/methods ; Animals ; Dilatation, Pathologic ; Disease Models, Animal ; Intestines/microbiology ; Short Bowel Syndrome/surgery* ; Surgical Stapling ; Swine
Abstract
OBJECTIVE/SUMMARY BACKGROUND DATA: Serial transverse enteroplasty (STEP) is a new intestinal lengthening procedure that has been shown to clinically increase bowel length. This study examined the impact of the STEP procedure upon intestinal function in a model of short bowel syndrome.
METHODS: Young pigs (n=10) had a reversed segment of bowel interposed to induce bowel dilatation. Five pigs underwent a 90% bowel resection with a STEP procedure on the remaining dilated bowel while 5 served as controls and had a 90% bowel resection without a STEP procedure. Determinations of nutritional status, absorptive capacity, and bacterial overgrowth were conducted 6 weeks after resection. Statistical comparisons were made by 2-sample t test (significance at P<0.05).
RESULTS: The STEP procedure lengthened the bowel from 105.2+/-7.7 cm to 152.2+/-8.3 cm (P<0.01). The STEP animals showed improved weight retention compared with controls (mean, -0.5%+/-1.8% body weight versus -17.6%+/-1.5%, P<0.001). Intestinal carbohydrate absorption, as measured by d-Xylose absorption and fat absorptive capacity as measured by serum vitamin D and triglyceride levels, were increased in the STEP group versus controls. Serum citrulline, a marker of intestinal mucosal mass, was significantly elevated in the STEP pigs compared with controls. None of the STEP animals but 4 of 5 control animals were noted to have gram-negative bacterial overgrowth in the proximal bowel.
CONCLUSIONS: STEP improves weight retention, nutritional status, intestinal absorptive capacity, and serum citrulline levels in a porcine short bowel model. A salutary effect upon bacterial overgrowth was also noted. These data support the use of this operation in short bowel syndrome.
Files in This Item:
T200600740.pdf Download
DOI
10.1097/01.sla.0000197704.76166.07
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Oh, Jung Tak(오정탁)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/109651
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