Buie W D, Thurston O G, vanAerde J E, Aherne F X, Thomson A B, Fedorak R N
Faculty of Medicine, University of Alberta, Edmonton, Canada.
J Pediatr Surg. 1993 Jan;28(1):102-9. doi: 10.1016/s0022-3468(05)80366-5.
This study compared the efficacy of a Bianchi bowel-lengthening procedure performed in residual ileum and jejunum of a 75% short bowel model. Eighteen female piglets underwent a 75% mid small bowel resection. After a 6-week period, animal weights were similar and pigs were randomly assigned to one of three treatment groups: (1) a control group receiving no further therapy; (2) a group receiving a Bianchi procedure in the residual jejunal segment; and (3) a group receiving a Bianchi procedure in the residual ileal segment. All were followed for a further 12 weeks. Jejunal Bianchi-treated short bowel animals demonstrated a greater final weight gain (78.8 +/- 4.9 kg) compared with nontreated short bowel (63.0 +/- 6.6 kg) and ileal Bianchi-treated short bowel groups (69.3 +/- 6.9 kg) in addition to a larger jejunal diameter. The increased weight gain in the jejunal Bianchi-treated group was not a consequence of initial bowel length, food intake, changes in bowel length, digestibility of nitrogen or fat, or nutritional status. Furthermore, kinetic constants for D-glucose absorption following 18 weeks of short-bowel syndrome demonstrated a lowered glucose maximal transport rate (Vmax) in animals with nontreated short bowel compared with sham-operated controls. Additionally, jejunal and ileal glucose Vmax was further lowered in the presence of a Bianchi procedure. We conclude that: (1) during short-bowel syndrome, body weight gain was significantly higher in animals when the Bianchi procedure was performed in jejunum; (2) the short-bowel syndrome decreased intestinal glucose absorption; and (3) the Bianchi procedure itself further impaired glucose transport.
本研究比较了在75%小肠模型的残余回肠和空肠中进行比安奇肠延长术的疗效。18只雌性仔猪接受了75%的小肠中段切除术。6周后，动物体重相似，猪被随机分配到三个治疗组之一：（1）不接受进一步治疗的对照组；（2）在残余空肠段接受比安奇手术的组；（3）在残余回肠段接受比安奇手术的组。所有组均再随访12周。与未治疗的短肠组（63.0±6.6千克）和回肠比安奇治疗的短肠组（69.3±6.9千克）相比，空肠比安奇治疗的短肠动物最终体重增加更大（78.8±4.9千克），且空肠直径更大。空肠比安奇治疗组体重增加的增加并非初始肠长度、食物摄入量、肠长度变化、氮或脂肪消化率或营养状况的结果。此外，短肠综合征18周后D-葡萄糖吸收的动力学常数表明，与假手术对照组相比，未治疗的短肠动物葡萄糖最大转运速率（Vmax）降低。此外，在进行比安奇手术的情况下，空肠和回肠葡萄糖Vmax进一步降低。我们得出以下结论：（1）在短肠综合征期间，在空肠进行比安奇手术时动物体重增加显著更高；（2）短肠综合征降低了肠道葡萄糖吸收；（3）比安奇手术本身进一步损害了葡萄糖转运。
