Bishop W P, Kim S I, Yamazato M, Yoshino H, Kimura K
Department of Pediatrics, University of Iowa College of Medicine, Iowa City 52242.
J Pediatr Surg. 1992 Aug;27(8):1061-5. doi: 10.1016/0022-3468(92)90560-t.
An isolated bowel segment (IBS) is a loop of intestine that has been freed from its mesenteric attachment after the development of vascular collaterals between the antimesenteric surface of the gut and the host organ. Surgical creation of such artificially vascularized isolated bowel segments is of interest to researchers for a variety of studies, and may be useful in the treatment of short bowel syndrome, allowing longitudinal division of the remaining small bowel to double its length. We created four surgical variants to study the ability of the collateral blood supply to maintain mucosal integrity in the presence or absence of normal luminal contents. In all groups, a collateral blood supply was created in a 5- to 7-cm segment of adult rat jejunum by hepatoenteropexy (Iowa model II). In Thiry-Vella (T-V) and isolated bowel segment (IBS) rats, this segment was exteriorized at both ends to exclude luminal contents. Control and IBS in continuity (IBS-C) loops were left in continuity. The mesentery of IBS and IBS-C rats was divided 5 weeks later, leaving the experimental segment entirely dependent on the collateral circulation. All animals were harvested at 7 weeks after the initial surgery. Tissues were analyzed for mucosal weight, protein content per centimeter of bowel, length of villi, depth of crypts, DNA content, and sucrase activity. We found that segments retaining luminal continuity had significantly higher mucosal weight and DNA content per centimeter of bowel compared with exteriorized loops.
孤立肠段(IBS)是一段肠管,在肠管的系膜对侧表面与宿主器官之间形成血管侧支后,已从其系膜附着处游离出来。外科手术创建这种人工血管化的孤立肠段对研究人员进行各种研究很有意义,并且可能有助于治疗短肠综合征,使剩余小肠纵向分割后长度翻倍。我们创建了四种手术变体,以研究在有无正常肠腔内容物的情况下,侧支血供维持黏膜完整性的能力。在所有组中,通过肝肠固定术(爱荷华模型II)在成年大鼠空肠的5至7厘米段创建侧支血供。在蒂里-韦拉(T-V)和孤立肠段(IBS)大鼠中,该段两端均外置以排除肠腔内容物。对照组和连续性孤立肠段(IBS-C)肠袢保持连续。5周后将IBS和IBS-C大鼠的系膜分开,使实验段完全依赖侧支循环。所有动物在初次手术后7周处死。分析组织的黏膜重量、每厘米肠管的蛋白质含量、绒毛长度、隐窝深度、DNA含量和蔗糖酶活性。我们发现,与外置肠袢相比,保持肠腔连续性的肠段每厘米肠管的黏膜重量和DNA含量显著更高。