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01-06-2018 | Original Article

Segmental reversal of distal small intestine in short bowel syndrome: a study on the influence on postoperative weight and intestinal topography in piglets

Authors: Pernille Kock Grave, Sabrina Valentin Thomsen, Pia Susanne Clark, Gunvor Iben Madsen, Niels Qvist, Mark Bremholm Ellebæk

Published in: Pediatric Surgery International | Issue 6/2018

Abstract

Purpose

The objective of the present study was to investigate the effect of segmental reversal of the distal 20 cm of the small intestine in piglets with induced SBS compared to controls with SBS alone. Primary endpoint was postoperative weight change over a period of 1 month. Secondary endpoints were the influence on cell proliferation and mucosal architecture shown by histological analysis.

Methods

Sixteen piglets underwent a 60% resection of the distal small intestine and were randomized into two groups. Group 1 short bowel syndrome alone (SBS) (n = 8) and group 2 with reversal of a distal small intestinal segment (SBS-RS) (n = 8). Body weight was measured daily and the pigs were euthanized after 1 month. Crypt depths, villus heights and muscle layers thicknesses were measured. For the evaluation of microvilli of the brush border of the epithelium and cell proliferation, immunohistochemical staining with Villin and Ki-67 was performed.

Results

No statistically significant differences were observed concerning weight gain. Mean ± SD weight gain was 2.31 ± 2.85 kg for SBS-RS and 2.03 ± 1.27 kg for SBS (p = 0.8). In the proximal jejunal segment a significant increase in villus heights was found in the SBS group and increase in the thickness of the circular and longitudinal muscle layers in the SBS-RS group. In the distal ileal segment the longitudinal muscle layer thicknesses were increased in the SBS group. Otherwise, no significant changes were found.

Conclusion

Reversal of a 20-cm distal segment showed no effect on weight gain, but there were some significant histological changes of unknown clinical significance.

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Title: Segmental reversal of distal small intestine in short bowel syndrome: a study on the influence on postoperative weight and intestinal topography in piglets
Authors: Pernille Kock Grave
Sabrina Valentin Thomsen
Pia Susanne Clark
Gunvor Iben Madsen
Niels Qvist
Mark Bremholm Ellebæk
Publication date: 01-06-2018
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Surgery International / Issue 6/2018
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-018-4269-6

At a glance: The STEP trials

Springer Medicine

Segmental reversal of distal small intestine in short bowel syndrome: a study on the influence on postoperative weight and intestinal topography in piglets

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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