The colonic patch graft as a new technique of enteroplasty: histological observations and absorptive functions

A colonic patch graft technique which consists of a three-staged procedure, was developed in order to diminish ileostomy complications and to reconstruct rectoanal function in patients with extensive aganglionosis. The basic data on creation of the colonic patch graft remains uncertain.

Using 20 experimental dogs, a colonic patch graft was created by forming a longitudinal side-to-side ileocolostomy, followed in 10 weeks by severance of the colonic mesentery which feeds the anastomosed colon segment. Five weeks after division of the primary blood supply, histological studies of the walls of the colonic graft were carried out in 10 dogs. Effect of severance of the colonic mesentery on water and electrolytes absorption through the ileocolostomy segment was evaluated by single perfusion method in 10 dogs.

The significant abnormality noted was marked thickening of the submucosal layer secondary to persistent lymphstasis. Other layers of the bowel wall were not abnormal including the mucosa, muscle layers, and intramural ganglion cells. The severance of the colonic mesentery belonging to the ileocolostomy segment did not affect its absorptive capacity for water and electrolytes.

The histological findings support the observation that absorptive function in the mucosa of the colonic patch graft is not significantly disturbed, although lymphstasis is observed in the submucosa.