Mesenteric Neovascularization with Distraction-induced Intestinal Growth: Enterogenesis

Overview

Journal Pediatr Surg Int

Specialties General Surgery
Pediatrics

Date 2012 Dec 12

PMID 23229341

Citations 8

Authors

Matthew W Ralls

Ryo Sueyoshi

Richard S Herman

Brent Utter

Isabel Czarnocki

Nancy Si

Jonathan Luntz

Diann Brei

Daniel H Teitelbaum

Affiliations

Soon will be listed here.

Abstract

Background: Distraction-induced enterogenesis, whereby the intestine lengthens with application of linear forces, is an emerging area which may provide a unique treatment for short bowel syndrome. With an increase in overall tissue mass, there is an increase in oxygen and nutrient demand. We hypothesized that a neovascularization within the mesentery is necessary to support the growing small bowel.

Methods: A curvilinear hydraulic device was used to induce growth within the small bowel of Yorkshire pigs, and the intestine was harvested after 14 days. High-resolution gross pictures were recorded of the mesentery at implantation and at harvest, and CT imaging of the bowel and mesentery was performed at harvest after dye injection.

Results: After 2 weeks of distraction, an average of 72.5 % (8.7 cm) bowel lengthening was achieved. Gross images of the mesentery between major vessels showed a blossoming of the microvasculature and this was confirmed by CT imaging with 3D reconstruction. Mesenteric sample taken from the distracted segment had a fourfold increase in the volume of microvasculature versus controls.

Conclusion: Enterogenesis results not only in increased bowel length, but also significant increase in the mesenteric microvascularity. Presumably, this sustains the lengthened segment after application of longitudinal forces.

Citing Articles

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