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Nutritional effects of the serial transverse enteroplasty procedure in experimental short bowel syndrome.
J Pediatr Surg. 2009 Aug; 44(8):1552-9.JP

Abstract

BACKGROUND/PURPOSE

The serial transverse enteroplasty (STEP) procedure appears beneficial clinically, but the mechanism(s) underlying these effects remains unclear. The present study evaluated the nutritional, hormonal, and morphologic effects of the STEP procedure in a rodent model of short bowel syndrome.

METHODS

With institutional animal care ethics approval, Sprague-Dawley rats underwent an 80% distal bowel resection, anastomosing the 30 cm remnant of jejunum to the ascending colon; at day 14, animals were randomly assigned to control or a STEP procedure (n = 8/group). Animals were pair-fed with normal chow; after a further 3 weeks, intestinal transit, hormonal and metabolic balance studies were done, and intestinal tissues were taken for analysis.

RESULTS

The STEP group had increased weight gain (resected: -0.34% +/- 2.9% vs STEP: 2.5% +/- 1.5%), increased bowel length (34.1 +/- 1.5 vs 36.9 +/- 2.2 cm), increased jejunal villus height (555 +/- 59 vs 635 +/- 65 microm), decreased rates of crypt cell apoptosis, increased expression of mRNA for the GLP-2 receptor, and increased postprandial production of glucagon-like peptide 2 (45 +/- 14 vs 65 +/- 12 pmol/L) (P < .05 by Student t test). There were no differences in intestinal transit; absorption of total calories, protein, fat, or carbohydrate; crypt cell proliferation rates; or the expression of intestinal transporter proteins (SGLT-1, GLUT-2, and GLUT-5).

CONCLUSIONS

The STEP procedure improves weight gain and augments gross and microscopic intestinal morphology in severe experimental short bowel syndrome. Postprandial GLP-2 levels are increased, as is the expression of the GLP-2 receptor; these mechanisms may contribute to these metabolic effects and may be useful in guiding the use of the STEP procedure clinically.

Authors+Show Affiliations

Alberta Children's Hospital, Department of Surgery and Gastrointestinal Research Group, Institution of Infection Immunity and Inflammation, Faculty of Medicine, University of Calgary, Health Science Center, Calgary, Alberta, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19635304

Citation

Kaji, Tatsuru, et al. "Nutritional Effects of the Serial Transverse Enteroplasty Procedure in Experimental Short Bowel Syndrome." Journal of Pediatric Surgery, vol. 44, no. 8, 2009, pp. 1552-9.
Kaji T, Tanaka H, Wallace LE, et al. Nutritional effects of the serial transverse enteroplasty procedure in experimental short bowel syndrome. J Pediatr Surg. 2009;44(8):1552-9.
Kaji, T., Tanaka, H., Wallace, L. E., Kravarusic, D., Holst, J., & Sigalet, D. L. (2009). Nutritional effects of the serial transverse enteroplasty procedure in experimental short bowel syndrome. Journal of Pediatric Surgery, 44(8), 1552-9. https://doi.org/10.1016/j.jpedsurg.2008.10.001
Kaji T, et al. Nutritional Effects of the Serial Transverse Enteroplasty Procedure in Experimental Short Bowel Syndrome. J Pediatr Surg. 2009;44(8):1552-9. PubMed PMID: 19635304.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nutritional effects of the serial transverse enteroplasty procedure in experimental short bowel syndrome. AU - Kaji,Tatsuru, AU - Tanaka,Hiroaki, AU - Wallace,Laurie E, AU - Kravarusic,Dragan, AU - Holst,Jens, AU - Sigalet,David L, PY - 2008/07/31/received PY - 2008/10/01/revised PY - 2008/10/01/accepted PY - 2009/7/29/entrez PY - 2009/7/29/pubmed PY - 2009/11/3/medline SP - 1552 EP - 9 JF - Journal of pediatric surgery JO - J Pediatr Surg VL - 44 IS - 8 N2 - BACKGROUND/PURPOSE: The serial transverse enteroplasty (STEP) procedure appears beneficial clinically, but the mechanism(s) underlying these effects remains unclear. The present study evaluated the nutritional, hormonal, and morphologic effects of the STEP procedure in a rodent model of short bowel syndrome. METHODS: With institutional animal care ethics approval, Sprague-Dawley rats underwent an 80% distal bowel resection, anastomosing the 30 cm remnant of jejunum to the ascending colon; at day 14, animals were randomly assigned to control or a STEP procedure (n = 8/group). Animals were pair-fed with normal chow; after a further 3 weeks, intestinal transit, hormonal and metabolic balance studies were done, and intestinal tissues were taken for analysis. RESULTS: The STEP group had increased weight gain (resected: -0.34% +/- 2.9% vs STEP: 2.5% +/- 1.5%), increased bowel length (34.1 +/- 1.5 vs 36.9 +/- 2.2 cm), increased jejunal villus height (555 +/- 59 vs 635 +/- 65 microm), decreased rates of crypt cell apoptosis, increased expression of mRNA for the GLP-2 receptor, and increased postprandial production of glucagon-like peptide 2 (45 +/- 14 vs 65 +/- 12 pmol/L) (P < .05 by Student t test). There were no differences in intestinal transit; absorption of total calories, protein, fat, or carbohydrate; crypt cell proliferation rates; or the expression of intestinal transporter proteins (SGLT-1, GLUT-2, and GLUT-5). CONCLUSIONS: The STEP procedure improves weight gain and augments gross and microscopic intestinal morphology in severe experimental short bowel syndrome. Postprandial GLP-2 levels are increased, as is the expression of the GLP-2 receptor; these mechanisms may contribute to these metabolic effects and may be useful in guiding the use of the STEP procedure clinically. SN - 1531-5037 UR - https://www.unboundmedicine.com/medline/citation/19635304/Nutritional_effects_of_the_serial_transverse_enteroplasty_procedure_in_experimental_short_bowel_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3468(08)00827-0 DB - PRIME DP - Unbound Medicine ER -