Nutritional Effects of A Short Reversed Jejunal Segment

Sako, Kumao; Gerszi, Kornel; Marchetta, Frank C.

doi:10.1001/archsurg.1964.01320060170030

Cited by 16 publications

(3 citation statements)

References 5 publications

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“…Reversal of short segments of jejunum or ileum (i.e., antiperistaltic) have been described and are usually placed just proximal to the small bowel-colonic junction ranging in length from 3 to 8 cm. [36][37][38][39] Anecdotal reports of slowed transit time and improved absorption exist. Complications described are mostly attributed to nutritional complications of intestinal failure, but also include partial or complete obstruction.…”

Section: Discussionmentioning

confidence: 99%

A multidisciplinary approach to the treatment of intestinal failure

Sudan

DiBaise

Torres

et al. 2005

Journal of Gastrointestinal Surgery

135

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Section: Discussionmentioning

confidence: 99%

A multidisciplinary approach to the treatment of intestinal failure

Sudan

DiBaise

Torres

et al. 2005

Journal of Gastrointestinal Surgery

135

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“…Aqui ressaltamos o uso dos piloros naturais como, por exemplo, o piloro ileocecal 9,10 . O uso de segmento em anisoperistalse não demonstra diminuição significante do trânsito, mas sim, em alguns estudos, aumento desse trânsito 11 . Em outros estudos há resultados satisfatórios 12 .…”

Section: Discussionunclassified

Confecção de piloros artificiais em íleo terminal sem secção de musculatura em ratos: estudo anátomo-patológico

Nunes

Caputo

Silva³

2003

Rev. Col. Bras. Cir.

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OBJETIVO: Estudar, experimentalmente, a diminuição do trânsito intestinal através de piloros artificiais no íleo terminal de ratos, sem secção da musculatura entérica. MÉTODO: O estudo foi realizado em 40 ratos distribuídos em dois grupos de 20 animais cada. Foram confeccionados quatro piloros no íleo terminal de cada animal, com pontos sero-musculares separados, distribuídos circunferencialmente na alça intestinal. O Grupo 1 foi morto com 15 dias e o Grupo 2, com 30 dias. Aferimos as medidas da circunferência do intestino no transoperatório e no momento da necrópsia. RESULTADOS: No Grupo 1 houve dilatação média de 3mm no nível do primeiro piloro e de 4,15mm no quarto piloro. No Grupo 2 a dilatação média foi de 7,50mm no primeiro piloro e de 5,75mm no quarto piloro. No estudo anátomo-patológico ficou evidente a formação bem definida dos piloros. CONCLUSÃO: Não é necessário remover ou seccionar a musculatura do intestino delgado, nem a secção do plexo nervoso próprio do intestino, para promover a dilatação intestinal com esse método e, como consequência, diminuir o trânsito intestinal.

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“…In reported cases, such an operation has resulted in slowed transit time and increased intestinal absorption, inducing weight gain and clinical improvement 6 –10 . Other authors, who undertook experimental intestinal resection followed by reversal in dogs, have also described the beneficial effect of reversed loops on transit time, which improves digestive and absorptive capacities, weight and survival 11 –15 . This can be explained by the fact that the insertion of a reversed segment induces a physiological partial intestinal obstruction allowing increased time for digestion of ingesta and absorption of digesta.…”

Section: Introductionmentioning

confidence: 99%

Reversed bowel segments for the treatment of short bowel syndrome: assessment of their minimal length in correlation with electromyographic pattern in the rat

Chabert

Pellissier

Eribon

2000

Neurogastroenterology Motil

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Reversal of a distal intestinal loop is a surgical therapy intended to cure rapid intestinal transit in short bowel syndrome. To be active, a reversed loop must present a retrograde propagation of electromyographic patterns and must not be so long as to cause total obstruction. The aim of the current study was to propose methods to calculate the minimal length of the intestinal reversed loop taking into consideration the two previous conditions. Intestinal electromyograms were recorded in 65 rats at short-term (4 days after surgery) and ten rats at long-term (50 days after surgery). Control rats demonstrated that the preprandial regular spiking activity (RSA) of the migrating myoelectrical complex (MMC) extended simultaneously a definite part of the intestine which corresponds to the minimal length to reverse. A similar result can be obtained from a trigonometric representation. Whatever the method, the minimal lengths allowing the recording of RSA decreased along the rat intestine from 6 cm (proximal jejunum) to 4 cm (distal ileum). The experiments demonstrated that shorter loops did not present the preprandial RSA. In conclusion, the minimal reversed length depends on intestinal electromyographic parameters and, thereby, on the intestinal level.

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Nutritional Effects of A Short Reversed Jejunal Segment

Cited by 16 publications

References 5 publications

A multidisciplinary approach to the treatment of intestinal failure

A multidisciplinary approach to the treatment of intestinal failure

Confecção de piloros artificiais em íleo terminal sem secção de musculatura em ratos: estudo anátomo-patológico

Reversed bowel segments for the treatment of short bowel syndrome: assessment of their minimal length in correlation with electromyographic pattern in the rat

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