Lillemoe K D, Berry W R, Harmon J W, Tai Y H, Weichbrod R H, Cogen M A
Surgery. 1982 Mar;91(3):293-300.
Growing new mucosa from remnants of small bowel remaining in patients with short-bowel syndrome might offer a strategy for solving this clinical problem. We have performed a series of experiments investigating the possibility of growing rabbit ileal mucosa on vascularized pedicle flaps of abdominal wall musculature based on the inferior epigastric artery. By patching a defect of distal ileum with a skeletal muscle flap, we were able to demonstrate bowel augmentation by neomucosal ingrowth. Light and scanning electron microscopy confirmed the presence of essentially normal mucosa with well-developed villi atop the skeletal muscle pedicle flap. The mucosa was stripped from the skeletal muscle and compared with stripped mucosa from adjacent ileum in the Ussing chamber in 11 rabbits. The electrophysiologic studies showed no significant difference between normal mucosa and neomucosa in short-circuit current (Isc), potential difference or tissue conductance. The addition of 10 mM glucose resulted in similar unidirectional glucose flux and increase in Isc in both tissues. Bile salt absorption was also similar in both tissues. We conclude that neomucosa can be grown on flaps of skeletal muscle and is similar to normal mucosa by microscopic and electrophysiologic evaluation.
利用短肠综合征患者残留的小肠残余组织培育新的黏膜，可能为解决这一临床问题提供一种策略。我们进行了一系列实验，研究在基于腹壁下动脉的腹壁肌肉组织带血管蒂皮瓣上培育兔回肠黏膜的可能性。通过用骨骼肌瓣修补回肠远端缺损，我们能够证明新黏膜向内生长可使肠腔扩大。光镜和扫描电镜证实，在骨骼肌带蒂皮瓣上存在基本正常的黏膜，其绒毛发育良好。从骨骼肌上剥离黏膜，并与11只兔子的相邻回肠剥离的黏膜在尤斯灌流小室中进行比较。电生理研究表明，正常黏膜和新黏膜在短路电流（Isc）、电位差或组织电导方面无显著差异。添加10 mM葡萄糖后，两种组织的单向葡萄糖通量相似，Isc均增加。两种组织的胆盐吸收也相似。我们得出结论，通过显微镜和电生理评估，新黏膜可在骨骼肌瓣上生长，且与正常黏膜相似。
