Helicoidal enteromyotomy in rats: an experimental model of intestinal lengthening

Short bowel syndrome (SBS) is a congenital or acquired condition of poor absorption resulting from a reduced surface of the enteric mucosa. In most cases, it spontaneously resolves via an adaptive process in the remaining intestine. Intestinal lengthening is one therapeutic method used for refractory SBS. The present study evaluates the intestinal changes and weight gains following a new lengthening technique (helicoidal enteromyotomy) performed in growing rats. Thirty Wistar rats underwent enteromyotomy (group I) in a 5-cm jejunal segment or laparotomy only (group II). No animal underwent intestinal resection. Postoperatively monitored weight was animals were sacrificed on the day 28. Measurements were made of the anterior and middle half-perimeters and the length of the marked-out intestinal segment. Two animals in group I were excluded due to infraction of the technique (perforation of the mucosa). Group I had an initial weight loss, although variance analysis (ANOVA) showed that the speed of the weight gain was similar in the two groups after the postoperative day 4 (P =.245). When the half-perimeter dimensions and length of the manipulated intestinal segment were compared, group I showed an increased caliber and length (P <.001, for both comparisons). There was no baseline difference in caliber between the two groups (P =.127). Our results led us to conclude that helicoidal enteromyotomy increases intestinal length and caliber without causing upstream dilatation or interfering in weight gain.