Isolated bowel segment (Iowa model 1): Technique and histological studies

Ienaga, Tetsuya; Kimura, Ken; Hashimoto, Kimio; Lee, Seong-Chel; Brakstad, Mark T; Soper, Robert T.

doi:10.1016/0022-3468(90)90200-s

Cited by 27 publications

(3 citation statements)

References 7 publications

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“…Isolated bowel segments, in which there is an imported blood supply to the antimesenteric border of a dilated bowel loop by attachment to the abdominal wall, have also been attempted. 67 A useful adjunct to bowel-lengthening procedures is the creation of a nipple valve. 68 This valve, tailored to cause proximal bowel dilation without obstruction, can facilitate a bowel-lengthening operation.…”

Section: Surgical Approaches To Ifmentioning

confidence: 99%

Pediatric Intestinal Failure: Nutrition, Pharmacologic, and Surgical Approaches

et al. 2007

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Intestinal failure (IF) is a condition where there is insufficient functional bowel to allow for adequate nutrient and fluid absorption to sustain adequate growth in children. Several etiologies can predispose to IF, including necrotizing enterocolitis, gastroschisis, and intestinal atresias. Intestinal rehabilitation can be seen as a 3-pronged strategy merging nutrition, pharmacologic, and surgical approaches to achieve the ultimate goal of enteral nutrition. Nutrition approaches should seek to facilitate transition from parenteral nutrition (PN) to enteral nutrition because prolonged use of PN is associated with severe morbidity and mortality. Enteral nutrition, on the other hand, promotes and enhances an adaptive response in the intestine. Medications used in the treatment of IF may help alleviate symptoms of diarrhea, bacterial overgrowth, and gastrointestinal dysmotility. Surgical procedures, such as longitudinal intestinal lengthening and tapering (LILT) or serial transverse enteroplasty (STEP), can increase mucosal surface area and may enhance intestinal adaptation. IF is a difficult disease process with a complex patient population and is best guided through this 3-pronged approach by a multidisciplinary team featuring surgeons, gastroenterologists, dietitians, pharmacists, and nurses.

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Section: Surgical Approaches To Ifmentioning

confidence: 99%

Pediatric Intestinal Failure: Nutrition, Pharmacologic, and Surgical Approaches

et al. 2007

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“…Ienaga et al. have shown that within 5–7 weeks, the small bowel segment can be separated from its mesenteric pedicle without mucosal ischemia 20 . Our model uses the ischemic IBS in which the mesenteric pedicle is divided 2 weeks after the first operation.…”

Section: Discussionmentioning

confidence: 99%

Analysis of mucosal regeneration and the expression profile of heat shock protein 70 in the isolated small bowel segment

Moriyama

Noguchi

Takeno

et al. 2002

Wound Repair Regeneration

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To investigate the mechanisms underlying the regeneration of the denervated small bowel segment from ischemic injury, we examined the heat shock protein 70 (HSP70) expression profile and compared it to the histopathological and proliferative changes seen in an isolated bowel segment using a rabbit model. Two weeks following the small bowel segment transplantation to the subcutaneous space, the vascular pedicle was sectioned. Next, the rabbits were divided into three groups based on the collection time of the isolated bowel segment (3, 7, and 14 days for Groups A, B, and C, respectively). The unsectioned small bowel segment was utilized as a control for each group. Histological studies showed that no experimental group recovered from mucosal injury. The bromodeoxyuridine labeling index showed that the more severe mucosal injury group had the highest bromodeoxyuridine incorporation. In the experimental groups, HSP70 immunoreactivity was intensely seen in the regenerating epithelial cells and inflammatory cells. In the control mucosa, HSP70 immunoreactivity was weakly seen in the subepithelial stromal tissue, crypt cells and not in epithelial cells. The present study shows that the isolated bowel segment requires longer periods for regeneration from ischemic injury and HSP70 may play an important role during the regeneration process.

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“…A seromuscular incision was made along the antimesenteric border of a jejunal segment, exposing the muscolaris mucosa. Corresponding incisions were made in a host organ: a sero-fascial incision on the undersurface of the abdominal wall in the Iowa model 1 ( 56 , 57 ); an incision on the liver capsule in the Iowa model 2 ( 58 ); a seromuscular incision on a bowel segment in the Iowa model 3 ( 59 ). The deserosed antimesenteric surface of the jejunal segment was then sutured to the host organ.…”

Section: Lengthening Proceduresmentioning

confidence: 99%

Autologous Intestinal Reconstruction Surgery in Short Bowel Syndrome: Which, When, and Why

et al. 2022

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Short bowel syndrome (SBS), secondary to any natural loss or after any extensive bowel resection for congenital malformations or acquired disease, is the most common cause of intestinal failure in children. Extensive introduction of parenteral nutrition (PN) has dramatically changed the outcome of these patients, allowing for long-term survival. The main goal in children with SBS remains to be increasing enteral tolerance and weaning from PN support. Post resection intestinal adaptation allows for achievement of enteral autonomy in a subset of these patients, but the inability to progress in enteral tolerance exposes others to long-term complications of PN. Autologous intestinal reconstruction surgery (AIRS) can facilitate the fulfilment of enteral autonomy, maximizing the absorptive potential of the remaining gut. All the different intestinal reconstruction techniques, from simple procedures like tapering, reversed segments, and colon interposition, to more complex lengthening procedures (LILT: longitudinal intestinal lengthening and tailoring, STEP: serial transverse enteroplasty, and SILT: spiral intestinal lengthening and tailoring) and techniques designed for peculiar problems like controlled intestinal tissue expansion or duodenal lengthening are presented. AIRS indications, clinical applications, and results reported in the literature are reviewed.

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Isolated bowel segment (Iowa model 1): Technique and histological studies

Cited by 27 publications

References 7 publications

Pediatric Intestinal Failure: Nutrition, Pharmacologic, and Surgical Approaches

Pediatric Intestinal Failure: Nutrition, Pharmacologic, and Surgical Approaches

Analysis of mucosal regeneration and the expression profile of heat shock protein 70 in the isolated small bowel segment

Autologous Intestinal Reconstruction Surgery in Short Bowel Syndrome: Which, When, and Why

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