Autologous gastro-intestinal reconstruction: the composite ileo-colic loop.
A reproducible technique was developed experimentally in pigs for construction of a 'composite bowel tube' (CBT) made up of ileal mucosa that was grafted to a mucosally denuded colonic muscle surface vascularised by the colonic mesentery. Macroscopic and microscopic studies at terminal laparotomy revealed a viable, mucosally lined, patent peristaltic loop of bowel in six of the eight animals. Two animals died after sloughing the grafted mucosa. In vivo absorption studies, using l-alanine as an index of amino acid absorption, showed a transport pattern through the grafted mucosa of the composite ileo-colic loop appropriate to ileum when compared with controls. The CBT constitutes another autologous gastro-intestinal reconstructive technique for redistribution of available absorptive mucosa over a longer intestinal length, and may therefore be of benefit in the management of the short-bowel syndrome.
The Royal Manchester Children's Hoapital, M27 4HA, Pendlebury, Manchester, UK.
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Bianchi
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Lendon
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Ward