Skip to main content
Erschienen in: Pediatric Surgery International 1/2023

01.12.2023 | Original Article

The effect of spring diameter on porcine ileal distraction enterogenesis

verfasst von: Fereshteh Salimi-Jazi, Anne-Laure Thomas, Talha Rafeeqi, Modupeola Diyaolu, Lauren S. Y. Wood, James C. Y. Dunn

Erschienen in: Pediatric Surgery International | Ausgabe 1/2023

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Spring-mediated distraction enterogenesis has proven to be successful for intestinal lengthening. We aimed to evaluate the effect of spring diameter mismatch on intestinal adaptation.

Methods

Juvenile mini-Yucatan pigs underwent placement of compressed nitinol springs with diameter of 10, 11, or 12 mm into the ileal lumen. Pigs were euthanized on postoperative day 7. The lengths, histology, total area of blood vessels, and enteric ganglia were evaluated.

Results

All spring groups exhibited significant ileal lengthening. Across the different diameters, spring-expanded segments were similar in terms of ileal lengthening, crypt height, muscular thickness, blood vessels, and enteric ganglia area.

Conclusion

Spring-mediated distraction enterogenesis is successful in the porcine ileum. A smaller diameter spring is as effective as a larger diameter spring in lengthening the ileum. Springs of varying diameters result in comparable structural changes in the ileum.
Literatur
1.
Zurück zum Zitat Massironi S, Cavalcoli F, Rausa E, Invernizzi P, Braga M, Vecchi M (2020) Understanding short bowel syndrome: current status and future perspectives. Dig Liver Dis 52(3):253–261CrossRefPubMed Massironi S, Cavalcoli F, Rausa E, Invernizzi P, Braga M, Vecchi M (2020) Understanding short bowel syndrome: current status and future perspectives. Dig Liver Dis 52(3):253–261CrossRefPubMed
2.
Zurück zum Zitat Stark R, Zupekan T, Bondada S, Dunn JC (2011) Restoration of mechanically lengthened jejunum into intestinal continuity in rats. J Pediatr Surg 46(12):2321–2326CrossRefPubMed Stark R, Zupekan T, Bondada S, Dunn JC (2011) Restoration of mechanically lengthened jejunum into intestinal continuity in rats. J Pediatr Surg 46(12):2321–2326CrossRefPubMed
3.
Zurück zum Zitat Sullins VF, Scott A, Wagner JP, Steinberger D, Lee SL, Wu BM et al (2014) Intestinal lengthening in an innovative rodent surgical model. J Pediatr Surg 49(12):1791–1794CrossRefPubMed Sullins VF, Scott A, Wagner JP, Steinberger D, Lee SL, Wu BM et al (2014) Intestinal lengthening in an innovative rodent surgical model. J Pediatr Surg 49(12):1791–1794CrossRefPubMed
4.
Zurück zum Zitat Jeppesen PB, Mortensen PB (1998) Significance of a preserved colon for parenteral energy requirements in patients receiving home parenteral nutrition. Scand J Gastroenterol 33(11):1175–1179CrossRefPubMed Jeppesen PB, Mortensen PB (1998) Significance of a preserved colon for parenteral energy requirements in patients receiving home parenteral nutrition. Scand J Gastroenterol 33(11):1175–1179CrossRefPubMed
5.
Zurück zum Zitat Infantino BJ, Mercer DF, Hobson BD, Fischer RT, Gerhardt BK, Grant WJ et al (2013) Successful rehabilitation in pediatric ultrashort small bowel syndrome. J Pediatr 163(5):1361–1366CrossRefPubMed Infantino BJ, Mercer DF, Hobson BD, Fischer RT, Gerhardt BK, Grant WJ et al (2013) Successful rehabilitation in pediatric ultrashort small bowel syndrome. J Pediatr 163(5):1361–1366CrossRefPubMed
6.
Zurück zum Zitat Sullins VF, Wagner JP, Walthers CM, Chiang EK, Lee SL, Wu BM et al (2014) Function of mechanically lengthened jejunum after restoration into continuity. J Pediatr Surg 49(6):971–974 (discussion 4-5)CrossRefPubMed Sullins VF, Wagner JP, Walthers CM, Chiang EK, Lee SL, Wu BM et al (2014) Function of mechanically lengthened jejunum after restoration into continuity. J Pediatr Surg 49(6):971–974 (discussion 4-5)CrossRefPubMed
7.
Zurück zum Zitat Hosseini HS, Wood LSY, Taylor JS, Dubrovsky G, Portelli KI, Thomas AL et al (2020) Biomechanical signaling and collagen fiber reorientation during distraction enterogenesis. J Mech Behav Biomed Mater 101:103425CrossRefPubMed Hosseini HS, Wood LSY, Taylor JS, Dubrovsky G, Portelli KI, Thomas AL et al (2020) Biomechanical signaling and collagen fiber reorientation during distraction enterogenesis. J Mech Behav Biomed Mater 101:103425CrossRefPubMed
8.
Zurück zum Zitat Shekherdimian S, Scott A, Chan A, Dunn JC (2009) Intestinal lengthening in rats after massive small intestinal resection. Surgery 146(2):291–295CrossRefPubMed Shekherdimian S, Scott A, Chan A, Dunn JC (2009) Intestinal lengthening in rats after massive small intestinal resection. Surgery 146(2):291–295CrossRefPubMed
9.
Zurück zum Zitat Dubrovsky G, Huynh N, Thomas AL, Shekherdimian S, Dunn JC (2019) Double plication for spring-mediated in-continuity intestinal lengthening in a porcine model. Surgery 165(2):389–392CrossRefPubMed Dubrovsky G, Huynh N, Thomas AL, Shekherdimian S, Dunn JC (2019) Double plication for spring-mediated in-continuity intestinal lengthening in a porcine model. Surgery 165(2):389–392CrossRefPubMed
10.
Zurück zum Zitat Demehri FR, Utter B, Freeman JJ, Fukatsu Y, Luntz J, Brei D et al (2016) Development of an endoluminal intestinal attachment for a clinically applicable distraction enterogenesis device. J Pediatr Surg 51(1):101–106CrossRefPubMed Demehri FR, Utter B, Freeman JJ, Fukatsu Y, Luntz J, Brei D et al (2016) Development of an endoluminal intestinal attachment for a clinically applicable distraction enterogenesis device. J Pediatr Surg 51(1):101–106CrossRefPubMed
11.
Zurück zum Zitat Rouch JD, Huynh N, Scott A, Chiang E, Wu BM, Shekherdimian S et al (2016) Scalability of an endoluminal spring for distraction enterogenesis. J Pediatr Surg 51(12):1988–1992CrossRefPubMed Rouch JD, Huynh N, Scott A, Chiang E, Wu BM, Shekherdimian S et al (2016) Scalability of an endoluminal spring for distraction enterogenesis. J Pediatr Surg 51(12):1988–1992CrossRefPubMed
12.
Zurück zum Zitat Huynh N, Dubrovsky G, Rouch JD, Scott A, Stelzner M, Shekherdimian S et al (2017) Feasibility and scalability of spring parameters in distraction enterogenesis in a murine model. J Surg Res 215:219–224CrossRefPubMed Huynh N, Dubrovsky G, Rouch JD, Scott A, Stelzner M, Shekherdimian S et al (2017) Feasibility and scalability of spring parameters in distraction enterogenesis in a murine model. J Surg Res 215:219–224CrossRefPubMed
13.
Zurück zum Zitat Tappenden KA (2014) Pathophysiology of short bowel syndrome: considerations of resected and residual anatomy. JPEN J Parenter Enteral Nutr 38(1 Suppl):14s–22sPubMed Tappenden KA (2014) Pathophysiology of short bowel syndrome: considerations of resected and residual anatomy. JPEN J Parenter Enteral Nutr 38(1 Suppl):14s–22sPubMed
14.
Zurück zum Zitat Nakashima Y, Masumoto K, Takada N, Taguchi T, Suita S (2004) A study of the difference in intestinal adaptation between the residual jejunum and the ileum in rats with short bowel syndrome. Fukuoka Igaku Zasshi 95(7):167–172PubMed Nakashima Y, Masumoto K, Takada N, Taguchi T, Suita S (2004) A study of the difference in intestinal adaptation between the residual jejunum and the ileum in rats with short bowel syndrome. Fukuoka Igaku Zasshi 95(7):167–172PubMed
15.
Zurück zum Zitat Wood LS, Hosseini HS, Diyaolu M, Thomas AL, Taylor JS, Dunn JC (2021) Mechanical lengthening of porcine small intestine with decreased forces. J Pediatr Surg 56(7):1192–1198CrossRefPubMed Wood LS, Hosseini HS, Diyaolu M, Thomas AL, Taylor JS, Dunn JC (2021) Mechanical lengthening of porcine small intestine with decreased forces. J Pediatr Surg 56(7):1192–1198CrossRefPubMed
16.
Zurück zum Zitat Dubrovsky G, Taylor JS, Thomas AL, Shekherdimian S, Dunn JCY (2020) Optimization of in-continuity spring-mediated intestinal lengthening. J Pediatr Surg 55(1):158–163CrossRefPubMed Dubrovsky G, Taylor JS, Thomas AL, Shekherdimian S, Dunn JCY (2020) Optimization of in-continuity spring-mediated intestinal lengthening. J Pediatr Surg 55(1):158–163CrossRefPubMed
17.
Zurück zum Zitat Jabaji Z, Stark R, Dunn JC (2013) Regeneration of enteric ganglia in mechanically lengthened jejunum after restoration into intestinal continuity. J Pediatr Surg 48(1):118–123CrossRefPubMed Jabaji Z, Stark R, Dunn JC (2013) Regeneration of enteric ganglia in mechanically lengthened jejunum after restoration into intestinal continuity. J Pediatr Surg 48(1):118–123CrossRefPubMed
18.
Zurück zum Zitat Spencer AU, Kovacevich D, McKinney-Barnett M, Hair D, Canham J, Maksym C et al (2008) Pediatric short-bowel syndrome: the cost of comprehensive care. Am J Clin Nutr 88(6):1552–1559CrossRefPubMed Spencer AU, Kovacevich D, McKinney-Barnett M, Hair D, Canham J, Maksym C et al (2008) Pediatric short-bowel syndrome: the cost of comprehensive care. Am J Clin Nutr 88(6):1552–1559CrossRefPubMed
19.
Zurück zum Zitat Tannuri U, Barros F, Tannuri AC (2016) Treatment of short bowel syndrome in children. Value of the Intestinal Rehabilitation Program. Rev Assoc Med Bras (1992) 62(6):575–583CrossRefPubMed Tannuri U, Barros F, Tannuri AC (2016) Treatment of short bowel syndrome in children. Value of the Intestinal Rehabilitation Program. Rev Assoc Med Bras (1992) 62(6):575–583CrossRefPubMed
20.
Zurück zum Zitat Scott A, Sullins VF, Steinberger D, Rouch JD, Wagner JP, Chiang E et al (2015) Repeated mechanical lengthening of intestinal segments in a novel model. J Pediatr Surg 50(6):954–957CrossRefPubMed Scott A, Sullins VF, Steinberger D, Rouch JD, Wagner JP, Chiang E et al (2015) Repeated mechanical lengthening of intestinal segments in a novel model. J Pediatr Surg 50(6):954–957CrossRefPubMed
21.
Zurück zum Zitat Puapong DP, Wu BM, Lam MM, Atkinson JB, Dunn JC (2006) Distension enterogenesis: increasing the size and function of small intestine. J Pediatr Surg 41(4):763–767CrossRefPubMed Puapong DP, Wu BM, Lam MM, Atkinson JB, Dunn JC (2006) Distension enterogenesis: increasing the size and function of small intestine. J Pediatr Surg 41(4):763–767CrossRefPubMed
22.
Zurück zum Zitat King B, Carlson G, Khalil BA, Morabito A (2013) Intestinal bowel lengthening in children with short bowel syndrome: systematic review of the Bianchi and STEP procedures. World J Surg 37(3):694–704CrossRefPubMed King B, Carlson G, Khalil BA, Morabito A (2013) Intestinal bowel lengthening in children with short bowel syndrome: systematic review of the Bianchi and STEP procedures. World J Surg 37(3):694–704CrossRefPubMed
23.
Zurück zum Zitat Park J, Puapong DP, Wu BM, Atkinson JB, Dunn JC (2004) Enterogenesis by mechanical lengthening: morphology and function of the lengthened small intestine. J Pediatr Surg 39(12):1823–1827CrossRefPubMed Park J, Puapong DP, Wu BM, Atkinson JB, Dunn JC (2004) Enterogenesis by mechanical lengthening: morphology and function of the lengthened small intestine. J Pediatr Surg 39(12):1823–1827CrossRefPubMed
24.
Zurück zum Zitat Huynh N, Rouch JD, Scott A, Chiang E, Wu BM, Shekherdimian S et al (2016) Spring-mediated distraction enterogenesis in-continuity. J Pediatr Surg 51(12):1983–1987CrossRefPubMed Huynh N, Rouch JD, Scott A, Chiang E, Wu BM, Shekherdimian S et al (2016) Spring-mediated distraction enterogenesis in-continuity. J Pediatr Surg 51(12):1983–1987CrossRefPubMed
25.
Zurück zum Zitat Scott A, Rouch JD, Huynh N, Chiang E, Shekherdimian S, Lee SL et al (2016) Mechanical lengthening in multiple intestinal segments in-series. J Pediatr Surg 51(6):957–959CrossRefPubMed Scott A, Rouch JD, Huynh N, Chiang E, Shekherdimian S, Lee SL et al (2016) Mechanical lengthening in multiple intestinal segments in-series. J Pediatr Surg 51(6):957–959CrossRefPubMed
26.
Zurück zum Zitat Portelli KI, Thomas A-L, Wood LS, Diyaolu M, Taylor JS, Dunn JCY (2021) Distraction enterogenesis in the murine colon. J Pediatr Surg 57(7):1377–1381CrossRefPubMed Portelli KI, Thomas A-L, Wood LS, Diyaolu M, Taylor JS, Dunn JCY (2021) Distraction enterogenesis in the murine colon. J Pediatr Surg 57(7):1377–1381CrossRefPubMed
27.
Zurück zum Zitat Guillen B, Atherton NS (2021) Short Bowel Syndrome. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright© 2021, StatPearls Publishing LLC Guillen B, Atherton NS (2021) Short Bowel Syndrome. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright© 2021, StatPearls Publishing LLC
28.
Zurück zum Zitat Dubrovsky G, Huynh N, Thomas AL, Shekherdimian S, Dunn JCY (2018) Double plication for spring-mediated intestinal lengthening of a defunctionalized Roux limb. J Pediatr Surg 53(9):1806–1810CrossRefPubMed Dubrovsky G, Huynh N, Thomas AL, Shekherdimian S, Dunn JCY (2018) Double plication for spring-mediated intestinal lengthening of a defunctionalized Roux limb. J Pediatr Surg 53(9):1806–1810CrossRefPubMed
29.
Zurück zum Zitat Huynh N, Dubrovsky G, Rouch JD, Scott A, Chiang E, Nguyen T et al (2018) Three-dimensionally printed surface features to anchor endoluminal spring for distraction enterogenesis. PLoS ONE 13(7):e0200529CrossRefPubMedPubMedCentral Huynh N, Dubrovsky G, Rouch JD, Scott A, Chiang E, Nguyen T et al (2018) Three-dimensionally printed surface features to anchor endoluminal spring for distraction enterogenesis. PLoS ONE 13(7):e0200529CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Dubrovsky G, Huynh N, Thomas AL, Shekherdimian S, Dunn JC (2019) Intestinal lengthening via multiple in-continuity springs. J Pediatr Surg 54(1):39–43CrossRefPubMed Dubrovsky G, Huynh N, Thomas AL, Shekherdimian S, Dunn JC (2019) Intestinal lengthening via multiple in-continuity springs. J Pediatr Surg 54(1):39–43CrossRefPubMed
31.
Zurück zum Zitat Mendoza J, Chang CY, Blalock CL, Atkinson JB, Wu BM, Dunn JC (2006) Contractile function of the mechanically lengthened intestine. J Surg Res 136(1):8–12CrossRefPubMed Mendoza J, Chang CY, Blalock CL, Atkinson JB, Wu BM, Dunn JC (2006) Contractile function of the mechanically lengthened intestine. J Surg Res 136(1):8–12CrossRefPubMed
32.
Zurück zum Zitat Portelli KI, Park JB, Taylor JS, Thomas AL, Stelzner M, Martin MG et al (2021) Intestinal adaptation following spring insertion into a roux limb in mice. J Pediatr Surg 56(2):346–351CrossRefPubMed Portelli KI, Park JB, Taylor JS, Thomas AL, Stelzner M, Martin MG et al (2021) Intestinal adaptation following spring insertion into a roux limb in mice. J Pediatr Surg 56(2):346–351CrossRefPubMed
33.
Zurück zum Zitat Diyaolu M, Thomas AL, Wood LS, Taylor J, Dunn JC (2021) Mesenteric neovascularization during spring-mediated intestinal lengthening. J Pediatr Surg 56(1):5–10CrossRefPubMed Diyaolu M, Thomas AL, Wood LS, Taylor J, Dunn JC (2021) Mesenteric neovascularization during spring-mediated intestinal lengthening. J Pediatr Surg 56(1):5–10CrossRefPubMed
Metadaten
Titel
The effect of spring diameter on porcine ileal distraction enterogenesis
verfasst von
Fereshteh Salimi-Jazi
Anne-Laure Thomas
Talha Rafeeqi
Modupeola Diyaolu
Lauren S. Y. Wood
James C. Y. Dunn
Publikationsdatum
01.12.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Surgery International / Ausgabe 1/2023
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-022-05300-1

Weitere Artikel der Ausgabe 1/2023

Pediatric Surgery International 1/2023 Zur Ausgabe

Neuer Typ-1-Diabetes bei Kindern am Wochenende eher übersehen

23.04.2024 Typ-1-Diabetes Nachrichten

Wenn Kinder an Werktagen zum Arzt gehen, werden neu auftretender Typ-1-Diabetes und diabetische Ketoazidosen häufiger erkannt als bei Arztbesuchen an Wochenenden oder Feiertagen.

Neue Studienergebnisse zur Myopiekontrolle mit Atropin

22.04.2024 Fehlsichtigkeit Nachrichten

Augentropfen mit niedrig dosiertem Atropin können helfen, das Fortschreiten einer Kurzsichtigkeit bei Kindern zumindest zu verlangsamen, wie die Ergebnisse einer aktuellen Studie mit verschiedenen Dosierungen zeigen.

Spinale Muskelatrophie: Neugeborenen-Screening lohnt sich

18.04.2024 Spinale Muskelatrophien Nachrichten

Seit 2021 ist die Untersuchung auf spinale Muskelatrophie Teil des Neugeborenen-Screenings in Deutschland. Eine Studie liefert weitere Evidenz für den Nutzen der Maßnahme.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.