Department of Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
Ann Surg. 2012 Feb;255(2):302-10. doi: 10.1097/SLA.0b013e318233097c.
Significant bowel lengthening can occur in an isolated intestinal segment with the use of linearly directed distractive forces, resulting in increased surface area and epithelial cell proliferation. We hypothesized that reimplantation of this lengthened intestine into normal jejunum would preserve this gain in intestinal length and function similar to normal jejunum.
An intestinal lengthening device was inserted into isolated jejunal segments in pigs, and fully expanded over 8 days. Lengthened segments were then reimplanted into normal intestinal continuity. Pigs were studied after another 28 days. Function was assessed by motility, mucosal enzyme activity, barrier function, and intestinal ion transport.
Lengthened segments were significantly longer than control segments and had nearly 2-fold greater surface area. Bowel lengthening was maintained 4 weeks after reimplantation. Motility after reimplantation was similar to nonoperated pigs. Barrier function, mucosal disaccharidase levels, and electrophysiologic measures declined immediately after lengthening but returned to nearly normal levels 28 days after reimplantation.
Bowel lengthening results in a transient decline in mucosal absorptive function and smooth muscle contractility. However, function approaches that of normal bowel after reimplantation into enteric flow. These data may support the use of this technique as a potential new option for the treatment of patients with short bowel syndrome.
线性定向牵张力可使孤立肠段显著延长，从而增加表面积和上皮细胞增殖。我们假设将这种延长的肠段重新植入正常空肠中，将保留这种肠段长度和功能的增加，类似于正常空肠。
将肠延长装置插入猪的孤立空肠段，并在 8 天内完全扩张。然后将延长的肠段重新植入正常肠连续性中。再过 28 天后，对猪进行研究。通过运动、黏膜酶活性、屏障功能和肠离子转运来评估功能。
延长的肠段明显长于对照肠段，表面积增加近 2 倍。在重新植入后 4 周保持肠延长。重新植入后的运动与未手术的猪相似。屏障功能、黏膜二糖酶水平和电生理测量值在延长后立即下降，但在重新植入 28 天后恢复到接近正常水平。
肠延长导致黏膜吸收功能和平滑肌收缩力暂时下降。然而，在重新植入肠内流动后，功能接近正常肠段。这些数据可能支持将该技术作为治疗短肠综合征患者的潜在新选择。
