Grosfeld J L, Cooney D R, Csicsko J F, Madura J A
Surgery. 1976 Aug;80(2):201-7.
Ninety percent jejunoileal bypass was performed in 20 growing (100 gram) male Sprague-Dawley (SD) and 15 male, genetically obese, growing (125 gram) Zucker "fat rats" (FR). Twenty SD and 15 FR unoperated rats of similar age and weight served as controls. Animals were evaluated for weight gain or loss, complications, and survival. At death (4 months), caliper measurements of long bones, vertebral column, pelvis, and skull were obtained, and brain, liver, spleen, and kidneys were excised and weighed. Liver and gonadal histology were obtained. The "fat fat" was more fragile, with a 20 percent anastomotic leak rate and a 33 percent mortality rate. The mortality rate was 5 percent (SD) and zero in controls. Bypassed animals showed growth retardation with weight of SD rats 31 percent (p less than 0.05) and FR's 19 percent of controls (p less than 0.05). Organ weights (liver, spleen, kidneys) were similar, except for a smaller brain in bypassed rats [SD 1.06 +/- 0.08 to 1.83 +/- 0.08 Gm. control (p less than 0.05), FR 1.2 +/- 0.12 to 1.68 +/- 0.09 control (p less than 0.025)]. Skeletal development was retarded significantly in bypassed rats [vertebral column, 125.9 +/- 3.5 to 138.3 +/- 3.9 mm. in controls (p less than .025); ilium, 39.4 +/- 1.1 to 46.2 +/- 1.5 mm. in controls (p less than 0.05); skull circumference, 20.2 +/- 0.03 to 22.5 +/- 0.05 mm. in controls (p less than 0.025)]. No increase in fatty infiltration of liver was observed. Spermatogenesis was diminished 30 percent (p less than 0.05) in bypassed (SD) animals. The data document significant morbidity and mortality rates, growth retardation, and diminished spermatogenesis in bypassed "adolescent" rats. These results imply that jejunoileal bypass may affect intellectual, skeletal, and reproductive development adversely and question the advisability of these procedures in growing subjects.
对20只生长中的（体重100克）雄性斯普拉格 - 道利（SD）大鼠和15只生长中的（体重125克）遗传性肥胖雄性 Zucker “肥鼠”（FR）进行了90%空肠回肠旁路手术。20只年龄和体重相近的未手术SD大鼠和15只未手术FR大鼠作为对照。评估动物的体重增加或减少、并发症及存活率。在动物死亡时（4个月），用卡尺测量长骨、脊柱、骨盆和颅骨，并切除脑、肝、脾和肾称重。进行肝和性腺组织学检查。“肥鼠”更为脆弱，吻合口漏发生率为20%，死亡率为33%。对照组的死亡率分别为5%（SD大鼠）和0。接受旁路手术的动物生长迟缓，SD大鼠体重为对照组的31%（p<0.05），FR大鼠体重为对照组的19%（p<0.05）。除了接受旁路手术的大鼠脑较小外（SD大鼠：1.06±0.08克至对照组的1.83±0.08克，p<0.05；FR大鼠：1.2±0.12克至对照组的1.68±0.09克，p<0.025），各器官重量（肝、脾、肾）相似。接受旁路手术的大鼠骨骼发育明显迟缓（脊柱：对照组为125.9±3.5毫米至138.3±3.9毫米，p<0.025；髂骨：对照组为39.4±1.1毫米至46.2±1.5毫米，p<0.05；头围：对照组为20.2±0.03毫米至22.5±0.05毫米，p<0.025）。未观察到肝脏脂肪浸润增加。接受旁路手术的（SD）动物精子发生减少30%（p<0.05）。这些数据表明接受旁路手术的“青春期”大鼠有显著的发病率和死亡率、生长迟缓以及精子发生减少。这些结果提示空肠回肠旁路手术可能对智力、骨骼和生殖发育产生不利影响，并对在生长中的个体进行这些手术的可取性提出质疑。
