Zachariou Z, Daum R, Beiler H A, Gorgas K
Department of Pediatric Surgery, University of Heidelberg, Germany.
Eur J Pediatr Surg. 1998 Aug;8(4):230-3. doi: 10.1055/s-2008-1071160.
There is no standard treatment for the short-bowel syndrome. The aims of surgical therapy are based on: slowing the intestinal transit, increasing the absorbing intestinal area and small-bowel transplantation. Searching for a new surgical treatment we developed an alternative for increasing the absorbing small-bowel area by means of autogenic allotopic small-bowel mucosa transplantation in beagle dogs. In young animals we isolated the transverse colon leaving the blood supply intact. Colonic continuity was reestablished and two abdominal stomata were performed at the ends of the isolated transverse colon. A week thereafter the colonic mucosa of the isolated transverse colon was surgically removed and autologous small-bowel mucosa was transplanted in the demucosed colon. The animals were then sacrificed 2, 4 and 6 weeks after transplantation and the colon-coat-ileal-mucosa complex (CIC) was histologically examined. The ileal mucosa could be transplanted in the demucosed colon showing histological characteristics of ileal mucosa. The circular muscle of the colon coat developed a hypertrophy which was present even 6 weeks after transplantation. In this study we could show that autogenic allotopic small-bowel mucosa transplantation is feasible in beagle dogs and may prove a novel method of small bowel expansion in cases of small-bowel syndrome.
短肠综合征尚无标准治疗方法。手术治疗的目的基于：减缓肠道蠕动、增加小肠吸收面积以及小肠移植。在寻找新的手术治疗方法时，我们开发了一种通过在比格犬身上进行自体异位小肠黏膜移植来增加小肠吸收面积的替代方法。在幼龄动物中，我们分离出横结肠并保留其血供。重建结肠连续性，并在分离出的横结肠两端做两个腹部造口。一周后，手术切除分离出的横结肠的结肠黏膜，并将自体小肠黏膜移植到去黏膜的结肠中。然后在移植后2周、4周和6周处死动物，对结肠-浆膜-回肠-黏膜复合体（CIC）进行组织学检查。回肠黏膜能够移植到去黏膜的结肠中，并呈现出回肠黏膜的组织学特征。结肠浆膜的环形肌出现肥大，甚至在移植后6周仍然存在。在本研究中，我们可以证明自体异位小肠黏膜移植在比格犬中是可行的，并且可能成为治疗短肠综合征时小肠扩张的一种新方法。
