Thompson J S, Hollingsed T C, Saxena S K
Omaha Veterans Administration Hospital, NE.
Arch Surg. 1988 Apr;123(4):428-30. doi: 10.1001/archsurg.1988.01400280034006.
Neomucosal growth on a serosal patch might increase intestinal surface area in the short-bowel syndrome but is limited by contraction of the patched defect. Our aim was to reduce contraction by mechanical or pharmacologic means. Ileal defects (2 x 5 cm) were patched with colon serosa in 14 rabbits. Group 1 (n = 5) had a plastic splint sutured to the defect edge. Group 2 (n = 4) received hydrocortisone acetate and vitamin A. Group 3 (n = 5) was the control group. Four weeks after patching there was significantly less contraction in groups 1 and 2 compared with group 3 (72.3% +/- 5.6% and 50.0% +/- 5.8% vs 31.9% +/- 1.8% initial defect size). Epithelial coverage of the defect was greater in groups 1 and 3 than in group 2. Disaccharidase activity of neomucosa and surrounding mucosa was significantly decreased in the steroid-treated rabbits. Contraction of a serosal patch can be reduced by mechanical and pharmacologic measures that may enhance the clinical applicability of this technique.
浆膜补片上的新黏膜生长可能会增加短肠综合征患者的肠表面积，但会受到补片缺损收缩的限制。我们的目的是通过机械或药物手段减少收缩。在14只兔子身上用结肠浆膜修补回肠缺损（2×5厘米）。第1组（n = 5）将塑料夹板缝合到缺损边缘。第2组（n = 4）接受醋酸氢化可的松和维生素A。第3组（n = 5）为对照组。修补四周后，与第3组相比，第1组和第2组的收缩明显减少（分别为初始缺损大小的72.3%±5.6%和50.0%±5.8%，而第3组为31.9%±1.8%）。第1组和第3组缺损的上皮覆盖程度大于第2组。在接受类固醇治疗的兔子中，新黏膜和周围黏膜的双糖酶活性显著降低。通过机械和药物措施可以减少浆膜补片的收缩，这可能会提高该技术的临床适用性。
