title: Significance of the Extent of Intestinal Resection on the Outcome of a Short-bowel Syndrome in a Porcine Model.
abstract: OBJECTIVE
  Insufficient data are available to determine the most suitable extent of intestinal resection required to induce short-bowel syndrome (SBS) in pigs. This study aimed to compare the three main SBS-models published.
  
  
  METHODS
  A 75%, 90%, or 100% mid-intestinal resection was performed in groups of n = 5 pigs each. Clinical (body weight, stool consistency) and biochemical (serum eletrolytes, citrulline, albumin, prealbumin, and transferrin) parameters were determined daily, functional (D-xylose resorption) and histological (intestinal villus length) parameters were determined after 2 weeks. A t-test and ANOVA were used for statistical analysis.
  
  
  RESULTS
  Only in the 100% group, we observed a persistent weight loss (13.6 ± 3.8%) and diarrhea, as well as a decrease in prealbumin-levels (41%) and transferrin levels (33%). Serum electrolytes remained stable in all groups during the observation period. Citrulline stabilized at different levels (100% group 13.9 ± 1.0 μmol/L; 90% group 18.8 ± 1.0 μmol/L; 75% group 26.3 ± 1.4 μmol/L; all p < .05). D-xylose resorption was lowest in the 100%, followed by 90% and 75% group (100% group 32.8 ± 4.9 mg/L; 90% group 50.0 ± 19.6 mg/L; 75% group 57.8 ± 8.8 mg/L; p = .393). Intestinal villus length decreased in all groups (100% group 11.0%; 90% group 14.0%; 75% group 19.1%).
  
  
  CONCLUSIONS
  75% intestinal resection is less suitable as an SBS model, as animals tend to recover remarkably. The 90% model is suitable for longer-term studies, as animals might survive longer due to partial compensation. Due to severe nutritional, biochemical, and physiological derangements, the 100% model can only be used for acute experiments and those immediately followed by small bowel transplantation.
authors.affiliation: a Division of Pediatric Surgery, University Hospital of Heidelberg , Heidelberg , Germany.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Frongia
authors.affiliation: b Department of General, Visceral and Transplantation Surgery, University Hospital of Heidelberg , Heidelberg , Germany.
authors.forename: Arash
authors.initials: A
authors.lastname: Nickkholgh
authors.affiliation: b Department of General, Visceral and Transplantation Surgery, University Hospital of Heidelberg , Heidelberg , Germany.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Hafezi M
authors.affiliation: b Department of General, Visceral and Transplantation Surgery, University Hospital of Heidelberg , Heidelberg , Germany.
authors.forename: Jalal
authors.initials: J
authors.lastname: Arvin
authors.affiliation: b Department of General, Visceral and Transplantation Surgery, University Hospital of Heidelberg , Heidelberg , Germany.
authors.forename: Arash
authors.initials: A
authors.lastname: Saffari
authors.affiliation: b Department of General, Visceral and Transplantation Surgery, University Hospital of Heidelberg , Heidelberg , Germany.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Golriz
authors.affiliation: b Department of General, Visceral and Transplantation Surgery, University Hospital of Heidelberg , Heidelberg , Germany.
authors.forename: Esvad
authors.initials: E
authors.lastname: Aydin
authors.affiliation: a Division of Pediatric Surgery, University Hospital of Heidelberg , Heidelberg , Germany.
authors.forename: Sandra
authors.initials: S
authors.lastname: Weih
authors.affiliation: a Division of Pediatric Surgery, University Hospital of Heidelberg , Heidelberg , Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Kessler
authors.affiliation: b Department of General, Visceral and Transplantation Surgery, University Hospital of Heidelberg , Heidelberg , Germany.
authors.forename: Golnaz
authors.initials: G
authors.lastname: Emami
authors.affiliation: b Department of General, Visceral and Transplantation Surgery, University Hospital of Heidelberg , Heidelberg , Germany.
authors.forename: Camelia
authors.initials: C
authors.lastname: Garoussi
authors.affiliation: c Department of Pediatrics, University Hospital of Heidelberg , Heidelberg , Germany.
authors.forename: Jürgen G
authors.initials: JG
authors.lastname: Okun
authors.affiliation: c Department of Pediatrics, University Hospital of Heidelberg , Heidelberg , Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Schmidt
authors.affiliation: c Department of Pediatrics, University Hospital of Heidelberg , Heidelberg , Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Thiel
authors.affiliation: d Department of Internal Medicine I and Clinical Chemistry, University Hospital of Heidelberg , Heidelberg , Germany.
authors.forename: Maik
authors.initials: M
authors.lastname: Brune
authors.affiliation: a Division of Pediatric Surgery, University Hospital of Heidelberg , Heidelberg , Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Günther
authors.affiliation: a Division of Pediatric Surgery, University Hospital of Heidelberg , Heidelberg , Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Holland-Cunz
authors.affiliation: b Department of General, Visceral and Transplantation Surgery, University Hospital of Heidelberg , Heidelberg , Germany.
authors.forename: Arianeb
authors.initials: A
authors.lastname: Mehrabi
mesh_terms: D000818:Animals; D002956:Citrulline / Q000097:blood; D003967:Diarrhea / Q000097:blood / Q000209:etiology; D004195:Disease Models, Animal; D004573:Electrolytes / Q000097:blood; D005260:Female; D007413:Intestinal Mucosa / Q000473:pathology*; D007421:Intestine, Small / Q000098:blood supply / Q000601:surgery*; D011228:Prealbumin / Q000032:analysis; D012709:Serum Albumin / Q000032:analysis; D012778:Short Bowel Syndrome; D034421:Sus scrofa; D014168:Transferrin / Q000032:analysis; D015431:Weight Loss
chemical_list: D004573:Electrolytes; D011228:Prealbumin; D012709:Serum Albumin; D014168:Transferrin; D002956:Citrulline
keywords: intestinal failure; intestinal resection; porcine model.; resection extent; short-bowel syndrome; swine model