title: Time- and segment-related changes of postresected intestine: a 4-dimensional model of intestinal adaptation.
abstract: OBJECTIVE
  The aim of the present study was to investigate the segment- and time-related changes in rat short bowel syndrome and construct a 4-dimensional (4D) geometrical model of intestinal adaptation.
  
  
  METHODS
  Sprague-Dawley rats were divided into 3 groups: 2-day, 7-day, and 15-day postresection groups in which 75% of the jejunoileum was removed. Histological and morphometrical parameters in the remaining proximal to distal intestinal segments, from the jejunum to the distal colon, were comparatively evaluated in the groups. The data were used to construct a 4D geometric model in which villi were considered as cylinders, and their surface area was expressed as cylinder lateral area.
  
  
  RESULTS
  Major adaptive changes were observed in the ileum consisting of an increase in both the diameter of base and the height of villi. A parallel reduction in their number/mm was observed. The resulting ileal architecture was characterized by a limited number of large villi. An opposite pattern was observed in the jejunum whose postresection structure consisted of an increased number of villi. No changes were observed in the colon. Postresection restructuring was early and faster in the ileum than in the jejunum resulting in an increase in absorptive area of 81.5% and 22.5% in the ileum and jejunum, respectively.
  
  
  CONCLUSIONS
  Postresection adaptation is intestinal segment-specific because all of the major changes occur in the ileum rather than in the jejunum. Sparing ileal segments during resection may improve the outcome of patients undergoing extensive intestinal resection. Our 4D model can be used to test interventions aimed at optimizing postresection intestinal adaptation.
authors: Department of Paediatrics, Pediatric Surgery Unit, Federico II° University of Naples, AORN Cardarelli, Naples, Italy.
authors: Vittoria
authors: V
authors: Buccigrossi
authors: Carla
authors: C
authors: Armellino
authors: Arturo
authors: A
authors: Tozzi
authors: Emanuele
authors: E
authors: Nicastro
authors: Ciro
authors: C
authors: Esposito
authors: Francesca
authors: F
authors: Alicchio
authors: Santolo
authors: S
authors: Cozzolino
authors: Alfredo
authors: A
authors: Guarino
mesh_terms: D000222:Adaptation, Physiological; D000818:Animals; D007082:Ileum / Q000473:pathology / Q000601:surgery*; D007408:Intestinal Absorption; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery*; D007583:Jejunum / Q000473:pathology / Q000601:surgery*; D008954:Models, Biological; D009929:Organ Size; D051381:Rats; D017207:Rats, Sprague-Dawley; D017208:Rats, Wistar; D012778:Short Bowel Syndrome / Q000473:pathology / Q000601:surgery*