Prematurity Reduces Functional Adaptation to Intestinal Resection in Piglets

Area of Science:

• Neonatal physiology
• Gastrointestinal surgery
• Developmental biology

Background:

• Necrotizing enterocolitis and congenital gastrointestinal malformations necessitate intestinal resection, increasing the risk of short bowel syndrome (SBS).
• Immediate intestinal adaptation following distal intestinal resection and jejunostomy placement may differ between preterm and term neonates.

Purpose of the Study:

• To investigate and compare immediate intestinal adaptation in preterm versus term neonates after distal intestinal resection and jejunostomy placement.
• To evaluate the impact of prematurity on the physiological response and intestinal recovery post-resection.

Main Methods:

• Preterm and term piglets underwent 50% distal intestinal resection with jejunostomy placement on day 2 of life.
• Post-surgery, piglets received parenteral nutrition with gradual enteral feeding (bovine colostrum) for 4-5 days.
• Intestinal tissue was analyzed for histological changes and digestive enzyme activities at multiple time points.

Main Results:

• While initial intestinal weight and enzyme activity increased similarly in both groups, term piglets exhibited significantly greater villus height, crypt depth, enzyme activities (sucrase, maltase, DPPIV), and hexose uptake capacity by days 6-7.
• Preterm piglets were more susceptible to postoperative complications, including hypoglycemia, respiratory distress, dehydration, and circulatory instability.
• Remnant intestine density and mucosal mass were comparable between preterm and term piglets.

Conclusions:

• Intestinal adaptation following resection is reduced in preterm neonates compared to term neonates due to physiological instability and intestinal immaturity.
• Studies on intestinal adaptation post-resection are feasible in both preterm and term piglets, but preterm piglets require intensive clinical support for managing short bowel syndrome (SBS).