Zusammenfassung
Gewebeexpander (auffüllbare Silikonballons) wurden bei sieben Schweinen in ein ausgeschaltetes Ileumsegment implantiert und anschließend über 8 bis 12 Wochen aufgefüllt. Die mittlere Volumenzunahme der Dünndarmschlinge lag beim Zwölffachen des Ausgangswertes (maximal 22,8fach). Neun Wochen nach Expanderentfernung und Wiedereinschaltung in die Kontinuität betrug das mittlere Endvolumen immer noch 500%. Histologisch fand sich eine Zunahme der Dicke aller Darmwandschichten, insbesondere der Tunica muscularis. Die mittlere in-vitro-l4C-Glukoseresorptionsleistung des wiedereingeschalteten Ileums lag über den Kontrollen. Eine mögliche Nutzung der Darmvergrößerung durch Expansion als Mastdarm-, Blasen- oder Magenersatz und zur Behandlung des Kurzdarmsyndroms werden diskutiert.
Summary
Tissue expanders (inflatable silicone balloons) were implanted into a bypassed ileum segment of seven pigs and consecutively filled over 8 to 12 weeks. The mean increase of the volume of the small bowel loops was 12 fold with a maximum of 22.8 times the original volume. The final volume 9 weeks after expander removal still presented an increase of 500%. Histologically there was an increase of the thickness of all layers of the bowel wall, especially in the tunica muscularis. The mucosa showed a value above normal in mean in vitro 14C-resorption capacity per surface area in the reintegrated bowel. Possible clinical applications of the augmentation of the gut by expansion as a rectum substitute after proctocolectomy, as a urinary bladder or stomach substitute, and for the treatment of short bowel syndrome are discussed.
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Stark, G.B., Dorer, A., Walgenbach, KJ. et al. The creation of a small bowel pouch by tissue expansion —an experimental study in pigs. Langenbecks Arch Chir 375, 145–150 (1990). https://doi.org/10.1007/BF00206807
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DOI: https://doi.org/10.1007/BF00206807