The effect of a reversed ileal segment and artificial valve on intestinal transit and absorption following colectomy and low ileo-rectal anastomosis in the dog

Williams, Norman S.; King, Rhodri

doi:10.1002/bjs.1800720303

Cited by 20 publications

(4 citation statements)

References 41 publications

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“…Although plasma PYY increased postprandially in all three groups, the increase in the IJT group (-F-) was greater than in the control (-⅙-) and sham operated (-□-) groups longer than 90 minutes. segment or creating a valve in the small intestine, 13 whereas others proposed constructing a jejunal Jpouch, 14 or interposing an ileocecal valve. 15 Although these procedures were designed to improve diarrhea by delaying small intestinal transit, none of these procedures has ever been clinically useful.…”

Section: Discussionmentioning

confidence: 99%

Ileojejunal Transposition Delays Gastric Emptying and Decreases Fecal Water Content in Dogs withTotal Colectomy

Ueno

Shibata

Naitö

et al. 2002

Diseases of the Colon &Amp; Rectum

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Section: Discussionmentioning

confidence: 99%

Ileojejunal Transposition Delays Gastric Emptying and Decreases Fecal Water Content in Dogs withTotal Colectomy

Ueno

Shibata

Naitö

et al. 2002

Diseases of the Colon &Amp; Rectum

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“…Reversed segments also alter the hormonal milieu after resection (3). Most experimental studies of reverse intestinal segments demonstrate slowed intestinal transit, improved absorption, reduced weight loss, and prolonged survival after intestinal resection, but some reports do not show beneficial effects (3,5,12).…”

Section: Discussionmentioning

confidence: 99%

Does Ileal Reverse Segment in Rats With Short Bowel Syndrome Change Intestinal Morphology?

Şencan,

Akçora,

Mir

et al. 2002

J. pediatr. gastroenterol. nutr.

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BackgroundThe primary goal of surgical therapy for short bowel syndrome is to increase intestinal absorptive capacity. Many surgical procedures have been described for this purpose. One of these is ileal reverse‐segment procedure. This procedure after massive small‐bowel resection is an alternative way to treat short bowel syndrome, but how it affects intestinal morphology in short bowel syndrome has not been investigated. The aim of this study is to investigate macroscopic and microscopic effects of reverse‐segment procedure on the short bowel.MethodsTwenty rats underwent resection of 80% of the small bowel. The rats were separated into two groups (n = 10). In the first group (reverse group), a reverse segment was formed by twisting a 2‐cm ileal segment 180°, without damaging its vascularity. In the second group (control group), a 2‐cm ileal segment was resected, preserving its mesentery, and end‐to‐end anastomosis was performed to maintain the intestinal passage. The segment was not twisted 180°. The 2‐cm proximal (jejunal) and distal (ileal) segments of the resected bowel were reserved for histologic investigation. Two months later, the rats were killed and the jejunal and ileal segments were evaluated morphologically.ResultsIn the reverse group, body weight and total intestinal length significantly increased (14% more than in the control group). The diameter of both proximal (jejunal) and distal (ileal) segments in the reverse group also increased 53.8% and 22.8%, respectively (P < 0.05). Histologically, crypt depth and villus height of the ileal segment in the reverse group increased 15.2% and 18.2% more than in the control group (P < 0.05). No histologic change was observed at the jejunal level except for intestinal muscle thickness.ConclusionsIleal reverse‐segment procedure in rats with short bowel syndrome 1) does not cause intestinal obstruction, 2) increases total bowel length and body weight, 3) increases the diameter of both jejunal and ileal segments, and 4) increases villus height and crypt depth only at the ileal level. For this reason, reverse‐segment procedure positively affects intestinal adaptation.

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“…In sp~iteren Studien wurde offenbar, dag die Partialfunktionen eines physiologischen intestinalen Sphinkters, n~imlich Passageverlangsamung, Verbesserung der intestinalen Absorption und bakteriologische Barriere von den einzelnen Ersatzmodellen in qualitativer und quantitativer Hinsicht sehr unterschiedlich imitiert werden [1,15,21]. Tierexperimentell scheint unter all diesen Ge-Abb.…”

Section: Diskussionunclassified

Ein intestinaler Neosphinkter (INS) durch umschriebene Muskelvermehrung Technische entwicklung und funktionelle evaluierung beim hund

Ecker¹,

Pistorius²,

Harbauer

et al. 1994

Langenbecks Arch Chir

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In an experimental study an intestinal neosphincter (INS) was constructed by modifying the principle of the ileocolic nipple-valve anastomosis by means of ultrasonic tissue fragmentation of the contacting serosa of the ileum and the corresponding mucosa of the ileum and colon. The healing of the muscle layers was studied histologically. The function of the INS was investigated in six dogs and compared intraindividually with that of the ileocecal valve and conventional end-to-end anastomosis. Morphologically the neospincters healed within 3 months without major fibrosis. The reference values of the aerobic and anaerobic bacterial counts in the terminal ileum were more than 2 logs lower than in the colon with the normal ileocecal valve, and after ileo-colonic end-to-end-anastomosis bacterial colonization of the terminal ileum was found both qualitatively and quantitatively. Subsequent interposition of the INS led to bacterial clearance of the terminal ileum. The median aerobic bacterial counts were lower by six logs and the an aerobic bacterial counts by 3 logs than in the colon. However, differences were not statistically significant owing to the wide variation in the individual values. Nevertheless, the demonstrable clearance of the terminal ileum could be explained by the orthograde passage with absolutely no stagnation and the relative competence of the INS in resisting retrograde pressure competence. In conclusion, ultrasonic fragmentation of the serosa and mucosa of the bowel allows construction of an INS from three muscle layers, which acts as a bacteriological barrier. Before it is introduced into the clinical setting its integration into the intestinal motility should be evaluated by further studies.

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The effect of a reversed ileal segment and artificial valve on intestinal transit and absorption following colectomy and low ileo-rectal anastomosis in the dog

Cited by 20 publications

References 41 publications

Ileojejunal Transposition Delays Gastric Emptying and Decreases Fecal Water Content in Dogs withTotal Colectomy

Ileojejunal Transposition Delays Gastric Emptying and Decreases Fecal Water Content in Dogs withTotal Colectomy

Does Ileal Reverse Segment in Rats With Short Bowel Syndrome Change Intestinal Morphology?

Ein intestinaler Neosphinkter (INS) durch umschriebene Muskelvermehrung Technische entwicklung und funktionelle evaluierung beim hund

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