Establishment of an immunocompetent nipple valve anastomosis to prevent faecal reflux after ileocolic resection in dogs.
OBJECTIVE
To construct an immunocompetent nipple valve anastomosis (NVA) to exclude faecal reflux and compare it with an end-to-end anastomosis to see if it would prevent recurrent inflammation caused by intraluminal bacterial antigens in Crohn's disease.


METHODS
Laboratory study.


METHODS
Teaching hospital, Germany.


METHODS
Two groups of six beagle dogs each of which had NVA or end-to-end anastomosis.


METHODS
Construction of a NVA by stapling the telescoped nipple, and replacing the ileal mucosa on the valve by colonic mucosa; end-to-end anastomosis.


METHODS
Radiological, bacteriological, angiographic, and morphometric results.


RESULTS
Absolute retrograde pressure-competence and free orthograde permeability of the NVA resulted in significantly lower intestinal bacterial counts compared with the end-to-end anastomosis (p < 0.05). Transposition of colonic mucosa was successful as demonstrated by revascularisation from the ileal nipple and looked normal on morphometry.


CONCLUSIONS
If NVA were constructed in patients with Crohn's disease, recurrences should be prevented, which would verify the immunopathogenetic hypothesis of new inflammation.
Ecker
K W
KW
Department of General, Abdominal and Vascular Surgery, University of Saarland, Homburg/Saar, Germany.
Pistorius
G
G
Menger
M D
MD
Feifel
G
G
D000714:Anastomosis, Surgical / Q000379:methods*; D000792:Angiography; D000818:Animals; D003106:Colon / Q000000981:diagnostic imaging / Q000601:surgery; D003424:Crohn Disease / Q000150:complications / Q000601:surgery*; D003672:Defecation; D004285:Dogs; D007082:Ileum / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control*