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Internal plication for spring confinement to lengthen intestine in a porcine model
BACKGROUND: Short bowel syndrome and its resultant nutritional deficiencies are the most common cause of intestinal failure. Significant intestinal lengthening using intraluminal springs is feasible in porcine models using an external plication technique. We hypothesize that an internal plication te...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9477332/ https://www.ncbi.nlm.nih.gov/pubmed/36107915 http://dx.doi.org/10.1371/journal.pone.0274612 |
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author | Rafeeqi, Talha A. Thomas, Anne-Laure Salimi-Jazi, Fereshteh Diyaolu, Modupeola Dunn, James C. Y. |
author_facet | Rafeeqi, Talha A. Thomas, Anne-Laure Salimi-Jazi, Fereshteh Diyaolu, Modupeola Dunn, James C. Y. |
author_sort | Rafeeqi, Talha A. |
collection | PubMed |
description | BACKGROUND: Short bowel syndrome and its resultant nutritional deficiencies are the most common cause of intestinal failure. Significant intestinal lengthening using intraluminal springs is feasible in porcine models using an external plication technique. We hypothesize that an internal plication technique will yield significant intestinal lengthening, which may lead to future endoscopic spring placement. METHODS: Uncompressed springs measuring 7.5 cm with a diameter of 1.0 cm were compressed to 2.0 cm. A gelatin-encapsulated compressed nitinol spring was inserted into the jejunal lumen of juvenile pigs and held in place with endoluminal sutures just proximal and distal to the spring-containing segment. A control segment distal to the spring was marked. Pigs were euthanized on postoperative day 7. Spring and control segments were collected for analyses. RESULTS: There was an average lengthening by 72% of the spring segment compared to the control segment. Two out of 7 springs stayed within both sets of plications and doubled in length. Histology showed normal mucosal integrity of the spring segment and plicated areas with similar muscular thickness but increased crypt depth and villus length compared to the control segment. CONCLUSION: Internal plication resulted in significant bowel lengthening. Five springs had slipped through proximal, distal or both sets of plications, resulting in less lengthening than those that remained fixed. A more consistent methodology for endoluminal suturing is needed to produce more lengthening. |
format | Online Article Text |
id | pubmed-9477332 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-94773322022-09-16 Internal plication for spring confinement to lengthen intestine in a porcine model Rafeeqi, Talha A. Thomas, Anne-Laure Salimi-Jazi, Fereshteh Diyaolu, Modupeola Dunn, James C. Y. PLoS One Research Article BACKGROUND: Short bowel syndrome and its resultant nutritional deficiencies are the most common cause of intestinal failure. Significant intestinal lengthening using intraluminal springs is feasible in porcine models using an external plication technique. We hypothesize that an internal plication technique will yield significant intestinal lengthening, which may lead to future endoscopic spring placement. METHODS: Uncompressed springs measuring 7.5 cm with a diameter of 1.0 cm were compressed to 2.0 cm. A gelatin-encapsulated compressed nitinol spring was inserted into the jejunal lumen of juvenile pigs and held in place with endoluminal sutures just proximal and distal to the spring-containing segment. A control segment distal to the spring was marked. Pigs were euthanized on postoperative day 7. Spring and control segments were collected for analyses. RESULTS: There was an average lengthening by 72% of the spring segment compared to the control segment. Two out of 7 springs stayed within both sets of plications and doubled in length. Histology showed normal mucosal integrity of the spring segment and plicated areas with similar muscular thickness but increased crypt depth and villus length compared to the control segment. CONCLUSION: Internal plication resulted in significant bowel lengthening. Five springs had slipped through proximal, distal or both sets of plications, resulting in less lengthening than those that remained fixed. A more consistent methodology for endoluminal suturing is needed to produce more lengthening. Public Library of Science 2022-09-15 /pmc/articles/PMC9477332/ /pubmed/36107915 http://dx.doi.org/10.1371/journal.pone.0274612 Text en © 2022 Rafeeqi et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Rafeeqi, Talha A. Thomas, Anne-Laure Salimi-Jazi, Fereshteh Diyaolu, Modupeola Dunn, James C. Y. Internal plication for spring confinement to lengthen intestine in a porcine model |
title | Internal plication for spring confinement to lengthen intestine in a porcine model |
title_full | Internal plication for spring confinement to lengthen intestine in a porcine model |
title_fullStr | Internal plication for spring confinement to lengthen intestine in a porcine model |
title_full_unstemmed | Internal plication for spring confinement to lengthen intestine in a porcine model |
title_short | Internal plication for spring confinement to lengthen intestine in a porcine model |
title_sort | internal plication for spring confinement to lengthen intestine in a porcine model |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9477332/ https://www.ncbi.nlm.nih.gov/pubmed/36107915 http://dx.doi.org/10.1371/journal.pone.0274612 |
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