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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Acknowledgements
Jakob Le Fèvre Harslund, Pernille Simonsen and Peter Bollen, Biomedical Laboratory, University of Southern Denmark, for technical assistance. Kirsten Dahl, Department of Pathology, Odense University Hospital, Odense, for the histological preparation. Ulrich Halekoh, Department of Public Health, University of Southern Denmark, for statistical assistance.
Funding
The study was funded by Odense University Hospital Research Foundation.
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The authors have no conflicts of interests to declare.
Ethical approval
The study was performed in compliance with the ethical standards for experimental studies on animals and was approved by The Animal Experiments Inspectorate (2015-15-0201-00551).
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Grave, P.K., Thomsen, S.V., Clark, P.S. et al. Segmental reversal of distal small intestine in short bowel syndrome: a study on the influence on postoperative weight and intestinal topography in piglets. Pediatr Surg Int 34, 671–677 (2018). https://doi.org/10.1007/s00383-018-4269-6
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DOI: https://doi.org/10.1007/s00383-018-4269-6