Establishment of an Immunocompetent Nipple Valve Anastomosis to Prevent Faecal Reflux after Ileocolic Resection in Dogs

• Published in: The European journal of surgery 2000, Vol.166 (5), p.409-414
• Main Authors: Ecker, Karl W., Pistorius, Georg, Menger, Michael D., Feifel, Gernot
• Format: Article
• Language: English
• ISSN: 1102-4151; 1741-9271
• DOI: 10.3109/110241500750008998

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. Design: Laboratory study. Setting: Teaching hospital, Germany. Animals: Two groups of six beagle dogs each of which had NVA or end-to-end anastomosis. Interventions: Construction of a NVA by stapling the telescoped nipple, and replacing the ileal mucosa on the valve by colonic mucosa; end-to-end anastomosis. Main outcome measures: 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. Conclusion: If NVA were constructed in patients with Crohn's disease, recurrences should be prevented, which would verify the immunopathogenetic hypothesis of new inflammation.