Rafeeqi Talha A, Thomas Anne-Laure, Salimi-Jazi Fereshteh, Diyaolu Modupeola, Lopez Nolan, Dunn James C Y
Division of Pediatric Surgery, Stanford University, Stanford, CA, USA.
Department of Bioengineering, Stanford University, Stanford, CA, USA.
Pediatr Surg Int. 2024 Dec 3;41(1):18. doi: 10.1007/s00383-024-05923-6.
We aim to apply our spring-mediated intestinal lengthening technique to adults and children with short bowel syndrome. We hypothesized that spring-mediated intestinal lengthening would be achieved in adult and juvenile pigs.
Adult and juvenile pigs underwent insertion of a compressed spring into the jejunum. Jejunum was plicated proximal and distal to the capsule for fixation and control jejunum was marked. Pigs were fed a liquid diet for one week. Spring and control segment lengths were compared using Brown-Forsythe and Welch ANOVA test.
Three adult pigs weighing 30.4 ± 2.1 kg and three juvenile pigs weighing 8.9 ± 1.2 kg underwent spring insertion without complications. Springs were compressed from 7.5 to 2 cm and had an average spring constant of 9.7 ± 1.2 N/m in adults and 5.4 ± 1.5 N/m in juveniles. Springs of 1.3 cm diameter were implanted in adults and springs of 1.0 cm diameter were implanted in juveniles. Spring segments lengthened on average by 86 ± 33% in adults (p = 0.04) and 123% in juveniles (p < 0.01) when compared to the initial length. There was no statistically significant difference in lengthening between juvenile and adult pigs (p = 0.2).
Intestinal lengthening was feasible in adult pigs but required a higher force for their larger diameter intestine compared to juvenile pigs.
我们旨在将弹簧介导的肠道延长技术应用于患有短肠综合征的成人和儿童。我们假设在成年和幼年猪中可实现弹簧介导的肠道延长。
成年和幼年猪在空肠插入一个压缩弹簧。在胶囊近端和远端对空肠进行折叠以固定,并标记对照空肠。给猪喂食流食一周。使用布朗 - 福赛斯和韦尔奇方差分析测试比较弹簧段和对照段的长度。
三只体重30.4±2.1千克的成年猪和三只体重8.9±1.2千克的幼年猪接受了弹簧插入,无并发症发生。弹簧在成年猪中从7.5厘米压缩至2厘米,平均弹簧常数为9.7±1.2牛/米,在幼年猪中为5.4±1.5牛/米。在成年猪中植入直径1.3厘米的弹簧,在幼年猪中植入直径1.0厘米的弹簧。与初始长度相比,成年猪的弹簧段平均延长了86±33%(p = 0.04),幼年猪延长了123%(p < 0.01)。幼年猪和成年猪之间的延长长度在统计学上无显著差异(p = 0.2)。
肠道延长在成年猪中是可行的,但与幼年猪相比,其直径较大的肠道需要更大的力。