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Preservation of intestinal motility after the serial transverse enteroplasty procedure in a large animal model of short bowel syndrome.
J Pediatr Surg. 2009 Jan; 44(1):229-35; discussion 235.JP

Abstract

INTRODUCTION

Serial transverse enteroplasty (STEP) has been shown to improve bowel function in short bowel syndrome. The effect of the STEP procedure on intestinal motility is not known, but some have hypothesized that it could disrupt bowel innervation and thus impair intestinal motility.

METHODS

Growing Yorkshire pigs (n = 7) underwent 3 operations at 6-week intervals: (1) reversal of 50 cm of jejunum, (2) 90% bowel resection +/- STEP to the proximal dilated bowel (4 STEP, 3 control), and (3) implantation of serosal strain gauges. At each operation, baseline and post-octreotide small intestinal motility was studied with continuously perfused manometry catheters using non-anticholinergic anesthesia. In addition, awake monitoring was performed using strain gauge analysis 1 week after the third operation. Characteristics of phase III of the migrating motor complex (MMC) were compared between and within groups using t test, chi(2), and analysis of variance, with significance set at P < .05.

RESULTS

Manometry data from the third surgery revealed no differences between groups or compared with baseline within groups for the presence and characteristics of phase III of the MMC. Specifically, the mean amplitude and frequency of phase III after octreotide, and both the mean baseline and mean octreotide-stimulated motility indices were equivalent. The duration of phase III after octreotide stimulation was significantly increased in the STEP animals, suggesting a potential benefit of the STEP procedure. Strain gauge analysis, performed in awake animals, confirmed no differences between the groups for basal and octreotide-stimulated characteristics of phase III of the MMC.

CONCLUSIONS

These preliminary data suggest that the STEP procedure in a porcine model of short bowel syndrome does not interfere with baseline or hormonally stimulated motility within the small bowel. These findings further support the STEP procedure as a safe option for the surgical management of short bowel syndrome.

Authors+Show Affiliations

Center for Advanced Intestinal Rehabilitation, Children's Hospital Boston and Harvard Medical School, MA 02115, USA. bmodi@partners.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19159748

Citation

Modi, Biren P., et al. "Preservation of Intestinal Motility After the Serial Transverse Enteroplasty Procedure in a Large Animal Model of Short Bowel Syndrome." Journal of Pediatric Surgery, vol. 44, no. 1, 2009, pp. 229-35; discussion 235.
Modi BP, Ching YA, Langer M, et al. Preservation of intestinal motility after the serial transverse enteroplasty procedure in a large animal model of short bowel syndrome. J Pediatr Surg. 2009;44(1):229-35; discussion 235.
Modi, B. P., Ching, Y. A., Langer, M., Donovan, K., Fauza, D. O., Kim, H. B., Jaksic, T., & Nurko, S. (2009). Preservation of intestinal motility after the serial transverse enteroplasty procedure in a large animal model of short bowel syndrome. Journal of Pediatric Surgery, 44(1), 229-35; discussion 235. https://doi.org/10.1016/j.jpedsurg.2008.10.045
Modi BP, et al. Preservation of Intestinal Motility After the Serial Transverse Enteroplasty Procedure in a Large Animal Model of Short Bowel Syndrome. J Pediatr Surg. 2009;44(1):229-35; discussion 235. PubMed PMID: 19159748.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preservation of intestinal motility after the serial transverse enteroplasty procedure in a large animal model of short bowel syndrome. AU - Modi,Biren P, AU - Ching,Y Avery, AU - Langer,Monica, AU - Donovan,Kate, AU - Fauza,Dario O, AU - Kim,Heung Bae, AU - Jaksic,Tom, AU - Nurko,Samuel, PY - 2008/10/04/received PY - 2008/10/07/accepted PY - 2009/1/23/entrez PY - 2009/1/23/pubmed PY - 2009/5/30/medline SP - 229-35; discussion 235 JF - Journal of pediatric surgery JO - J Pediatr Surg VL - 44 IS - 1 N2 - INTRODUCTION: Serial transverse enteroplasty (STEP) has been shown to improve bowel function in short bowel syndrome. The effect of the STEP procedure on intestinal motility is not known, but some have hypothesized that it could disrupt bowel innervation and thus impair intestinal motility. METHODS: Growing Yorkshire pigs (n = 7) underwent 3 operations at 6-week intervals: (1) reversal of 50 cm of jejunum, (2) 90% bowel resection +/- STEP to the proximal dilated bowel (4 STEP, 3 control), and (3) implantation of serosal strain gauges. At each operation, baseline and post-octreotide small intestinal motility was studied with continuously perfused manometry catheters using non-anticholinergic anesthesia. In addition, awake monitoring was performed using strain gauge analysis 1 week after the third operation. Characteristics of phase III of the migrating motor complex (MMC) were compared between and within groups using t test, chi(2), and analysis of variance, with significance set at P < .05. RESULTS: Manometry data from the third surgery revealed no differences between groups or compared with baseline within groups for the presence and characteristics of phase III of the MMC. Specifically, the mean amplitude and frequency of phase III after octreotide, and both the mean baseline and mean octreotide-stimulated motility indices were equivalent. The duration of phase III after octreotide stimulation was significantly increased in the STEP animals, suggesting a potential benefit of the STEP procedure. Strain gauge analysis, performed in awake animals, confirmed no differences between the groups for basal and octreotide-stimulated characteristics of phase III of the MMC. CONCLUSIONS: These preliminary data suggest that the STEP procedure in a porcine model of short bowel syndrome does not interfere with baseline or hormonally stimulated motility within the small bowel. These findings further support the STEP procedure as a safe option for the surgical management of short bowel syndrome. SN - 1531-5037 UR - https://www.unboundmedicine.com/medline/citation/19159748/Preservation_of_intestinal_motility_after_the_serial_transverse_enteroplasty_procedure_in_a_large_animal_model_of_short_bowel_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3468(08)00900-7 DB - PRIME DP - Unbound Medicine ER -