title: Establishment of an immunocompetent nipple valve anastomosis to prevent faecal reflux after ileocolic resection in dogs.
abstract: 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.
authors.affiliation: Department of General, Abdominal and Vascular Surgery, University of Saarland, Homburg/Saar, Germany.
authors.forename: K W
authors.initials: KW
authors.lastname: Ecker
authors.forename: G
authors.initials: G
authors.lastname: Pistorius
authors.forename: M D
authors.initials: MD
authors.lastname: Menger
authors.forename: G
authors.initials: G
authors.lastname: Feifel
mesh_terms: 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*