Walters A M, Zinsmeister A R, Sarr M G
Department of Surgery, Mayo Clinic, Rochester, Minnesota 55905.
Dig Dis Sci. 1994 Apr;39(4):843-50. doi: 10.1007/BF02087432.
Canine jejunoileal transplantation induces an early profuse watery diarrhea of uncertain etiology. Our aim was to determine the temporal effects of a canine model of jejunoileal autotransplantation (a model devoid of confounding effects of ischemia-reperfusion or immune rejection) on basal jejunal and ileal absorption of water and electrolytes to determine if impaired absorption is responsible for the diarrhea. Our hypothesis was that net absorption of water and electrolytes in an enterically isolated loop would decrease after jejunoileal transplantation. Four groups of dogs (N > or = 6) were prepared with 80-cm modified Thiry-Vella loops: group I, neurally intact jejunum; group II, autotransplanted jejunum; group III, neurally intact ileum; and group IV, autotransplanted ileum. The loops were perfused for 3 hr with 150 mM NaCl at 3 ml/min under fasted conditions; transit time through the loop was determined by bolus of a nonabsorbable marker. Dogs were studied on three separate days at one, two, eight, and nine weeks postoperatively. Net absorptive fluxes of water and electrolytes and transit times were similar (P > 0.05) between neurally intact and autotransplant groups (group I vs II and group III vs IV) at each time point. Ileal loops absorbed more than jejunal loops, and transit was slower in ileal loops (each P < 0.05). Our findings suggest that, despite the obligate disruption of extrinsic innervation, enteric (intrinsic) neural continuity, and lymphatic drainage that accompanies this canine model of jejunoileal autotransplantation, net basal absorptive function of water and electrolytes during the fasted state was not decreased nor was transit altered either in jejunum or ileum.(ABSTRACT TRUNCATED AT 250 WORDS)
犬空肠回肠移植会引发病因不明的早期大量水样腹泻。我们的目的是确定空肠回肠自体移植犬模型(一个不存在缺血再灌注或免疫排斥混杂效应的模型)对空肠和回肠基础水和电解质吸收的时间影响,以确定吸收受损是否是腹泻的原因。我们的假设是空肠回肠移植后,肠道隔离肠袢中水和电解质的净吸收会减少。四组犬(每组n≥6)制备了80厘米改良的Thiry-Vella肠袢:第一组,神经完整的空肠;第二组,自体移植空肠;第三组,神经完整的回肠;第四组,自体移植回肠。在禁食条件下,以3毫升/分钟的速度用150毫摩尔氯化钠对肠袢灌注3小时;通过肠袢的转运时间由不可吸收标记物推注确定。在术后1周、2周、8周和9周的三个不同日期对犬进行研究。在每个时间点,神经完整组和自体移植组(第一组与第二组以及第三组与第四组)之间水和电解质的净吸收通量以及转运时间相似(P>0.05)。回肠肠袢的吸收多于空肠肠袢,且回肠肠袢的转运较慢(每组P<0.05)。我们的研究结果表明,尽管该犬空肠回肠自体移植模型必然会破坏外在神经支配、肠内(内在)神经连续性和淋巴引流,但禁食状态下空肠和回肠中水和电解质的基础净吸收功能并未降低,转运也未改变。(摘要截短于250字)