The creation of a small bowel pouch by tissue expansion--an experimental study in pigs.
Tissue expanders (inflatable silicone balloons) were implanted into a bypassed ileum segment of seven pigs and consecutively filled over 8 to 12 weeks. The mean increase of the volume of the small bowel loops was 12 fold with a maximum of 22.8 times the original volume. The final volume 9 weeks after expander removal still presented an increase of 500%. Histologically there was an increase of the thickness of all layers of the bowel wall, especially in the tunica muscularis. The mucosa showed a value above normal in mean in vitro 14C-resorption capacity per surface area in the reintegrated bowel. Possible clinical applications of the augmentation of the gut by expansion as a rectum substitute after proctocolectomy, as a urinary bladder or stomach substitute, and for the treatment of short bowel syndrome are discussed.
Stark
G B
GB
Division of Plastic Surgery, Tulane University Medical Center, New Orleans.
Dorer
A
A
Walgenbach
K J
KJ
Grünwald
F
F
Jaeger
K
K
D000818:Animals; D005743:Gastrectomy / Q000379:methods; D007081:Ileostomy / Q000379:methods; D007082:Ileum / Q000473:pathology / Q000601:surgery*; D007408:Intestinal Absorption / Q000502:physiology; D007413:Intestinal Mucosa / Q000473:pathology; D012778:Short Bowel Syndrome / Q000601:surgery; D013552:Swine; D013556:Swine, Miniature; D015626:Tissue Expansion / Q000379:methods*; D015625:Tissue Expansion Devices; D014547:Urinary Diversion / Q000379:methods