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Rat Mesentery Exteriorization: A Model for Investigating the Cellular Dynamics Involved in Angiogenesis
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Mesenteric neovascularization during spring-mediated intestinal lengthening.

Modupeola Diyaolu1, Anne-Laure Thomas1, Lauren Sy Wood1

  • 1Department of Surgery, Division of Pediatric Surgery, Stanford University School of Medicine, Stanford, CA, USA.

Journal of Pediatric Surgery
|November 4, 2020
PubMed
Summary

Spring-mediated distraction enterogenesis successfully lengthened porcine jejunum, significantly increasing mesenteric blood vessels. This novel approach shows promise for treating short gut syndrome by enhancing vascularization in growing intestinal segments.

Keywords:
Distraction enterogenesisNeovascularizationShort gut syndromeSpring-mediated lengthening

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Area of Science:

  • Gastroenterology
  • Regenerative Medicine
  • Surgical Innovation

Background:

  • Short gut syndrome presents limited treatment options due to malabsorption from reduced bowel length.
  • Spring-mediated distraction enterogenesis is a novel approach to lengthen the bowel.
  • Evaluating mesenteric neovascularization is crucial for assessing the viability of lengthened intestine.

Purpose of the Study:

  • To assess the impact of spring-mediated enterogenesis on mesenteric neovascularization in porcine jejunum.
  • To quantify changes in both macroscopic and microscopic blood vessel density after intestinal lengthening.
  • To determine if spring-mediated lengthening stimulates local vascular recruitment.

Main Methods:

  • Female juvenile Yucatan pigs underwent jejunal implantation of nitinol springs via laparotomy.
  • Macroscopic mesenteric blood vessels were counted before and after lengthening.
  • Histologic analysis evaluated microscopic vasculature, including arterioles and venules.

Main Results:

  • A statistically significant increase in macroscopic mesenteric blood vessels was observed post-lengthening (1.9 to 4.7 vessels).
  • Significant increases in the density of both arterioles (3.0 to 7.0 vessels/mm) and venules (4.0 to 8.0 vessels/mm) were noted.
  • The results indicate enhanced vascularization in response to intestinal lengthening.

Conclusions:

  • Intestinal segments lengthened using intraluminal springs showed a greater number of macroscopic and microscopic mesenteric vessels.
  • This suggests that spring-mediated enterogenesis promotes local mesenteric changes to support blood supply to the growing intestine.
  • The findings support spring-mediated distraction enterogenesis as a potential therapeutic strategy for short gut syndrome.