title: Prematurity Reduces Functional Adaptation to Intestinal Resection in Piglets.
abstract: BACKGROUND
  Necrotizing enterocolitis and congenital gastrointestinal malformations in infants often require intestinal resection, with a subsequent risk of short bowel syndrome (SBS). We hypothesized that immediate intestinal adaptation following resection of the distal intestine with placement of a jejunostomy differs between preterm and term neonates.
  
  
  METHODS
  Preterm or term piglets were born by cesarean section and fed enterally for 2 days. On day 2, piglets were subjected to 50% distal intestinal resection with placement of a jejunostomy. On the following 4-5 days, piglets received parenteral nutrition with gradually increasing doses of enteral nutrition (bovine colostrum). Intestinal tissue samples were collected at delivery and 2 and 6-7 days after birth for histological examination and assessment of digestive enzyme activities.
  
  
  RESULTS
  Preterm and term piglets showed similar increases in intestinal weight and digestive enzyme activities from birth to 2 days. On days 6-7 after birth, the remnant intestine showed a similar density (g/cm) and mucosal mass in term and preterm piglets, but villus height, crypt depth, enzyme activities (sucrase, maltase, dipeptidyl peptidase IV [DPPIV]), and hexose uptake capacity were significantly higher in term piglets (P < .05). Preterm piglets were more prone to develop hypoglycemia, respiratory distress syndrome, dehydration, and circulatory instability after surgery compared with term piglets.
  
  
  CONCLUSIONS
  Studies on intestinal adaptation after resection are feasible in both preterm and term piglets, but intensive clinical support is required when rearing preterm piglets with SBS. Physiological instability and immaturity of the intestine may explain the fact that immediate adaptation after resection is reduced in preterm vs term neonates.
authors.affiliation: Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
authors.forename: Lise
authors.initials: L
authors.lastname: Aunsholt
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Thymann
authors.affiliation: Department of Surgery, Odense University Hospital, Odense, Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Qvist
authors.affiliation: Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Sigalet
authors.affiliation: Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
authors.forename: Steffen
authors.initials: S
authors.lastname: Husby
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark psa@life.ku.dk.
authors.forename: Per Torp
authors.initials: PT
authors.lastname: Sangild
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D004195:Disease Models, Animal; D004750:Enteral Nutrition; D020345:Enterocolitis, Necrotizing; D007413:Intestinal Mucosa / Q000503:physiopathology; D007421:Intestine, Small / Q000503:physiopathology* / Q000601:surgery*; D007582:Jejunostomy; D010288:Parenteral Nutrition; D012778:Short Bowel Syndrome / Q000503:physiopathology / Q000628:therapy; D013552:Swine
keywords: adaptation; preterm; short bowel syndrome; term