Sullins Veronica F, Scott Andrew, Wagner Justin P, Steinberger Doug, Lee Steven L, Wu Benjamin M, Dunn James C Y
Division of Pediatric Surgery, Department of Surgery, University of California, Los Angeles, CA, USA.
Department of Bioengineering, University of California, Los Angeles, CA, USA.
J Pediatr Surg. 2014 Dec;49(12):1791-4. doi: 10.1016/j.jpedsurg.2014.09.022. Epub 2014 Oct 1.
Current animal models of mechanical lengthening separate intestinal segments from enteric continuity. Such models are difficult to use for repeated lengthening procedures and result in intestinal tissue loss during restoration into continuity. We sought to create a novel surgical model to allow multiple lengthening procedures for the purpose of maximizing the net increase in tissue after intestinal lengthening.
A Roux-en-y jejunojejunostomy with a 6-cm blind-ended Roux limb was created in the proximal jejunum of rats. Encapsulated 1-cm polycaprolactone springs were placed into the closed end of the roux limb and secured with a vessel loop. After 4weeks, lengthened segments and normal jejunum were retrieved for histologic analysis.
Jejunal segments were lengthened from 1.0cm to 3.0cm. Lengthened segments had increased smooth muscle thickness, fewer submucosal ganglia, and similar numbers of myenteric ganglia compared to normal intestine. When compared to normal jejunal mucosa, lengthened segments demonstrated unchanged villus height and increased crypt depth.
We created an innovative surgical model for intestinal lengthening and successfully lengthened jejunal segments with a degradable spring. The Roux-en-y model may allow the use of a degradable spring for the treatment of short bowel syndrome.
目前的机械延长动物模型将肠段与肠道连续性分离。此类模型难以用于重复延长手术，且在恢复连续性过程中会导致肠组织丢失。我们试图创建一种新型手术模型，以便进行多次延长手术，从而使肠延长后组织的净增加最大化。
在大鼠空肠近端创建一个带有6厘米盲端Roux袢的Roux-en-y空肠空肠吻合术。将封装好的1厘米聚己内酯弹簧置于Roux袢的封闭端，并用血管环固定。4周后，取出延长段和正常空肠进行组织学分析。
空肠段从1.0厘米延长至3.0厘米。与正常肠相比，延长段的平滑肌厚度增加，黏膜下神经节减少，肌间神经节数量相似。与正常空肠黏膜相比，延长段的绒毛高度不变，隐窝深度增加。
我们创建了一种用于肠延长的创新手术模型，并成功地用可降解弹簧延长了空肠段。Roux-en-y模型可能允许使用可降解弹簧治疗短肠综合征。
