Enterogenesis by mechanical lengthening: Morphology and function of the lengthened small intestine

• Published in: Journal of pediatric surgery 2004-12, Vol.39 (12), p.1823-1827
• Main Authors: Park, Jinyoung, Puapong, Devin P., Wu, Benjamin M., Atkinson, James B., Dunn, James C.Y.
• Format: Article
• Language: English
• Subjects: alkaline phosphatase; Animals; Biomechanical Phenomena; intestinal lengthening; Intestine, Small - enzymology; Intestine, Small - growth & development; Intestine, Small - pathology; lactase; Male; Mechanical force; muscular hypertrophy; Rats; Rats, Sprague-Dawley; short bowel syndrome
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2004.08.022

The purpose of this study is to evaluate the function of the mechanically lengthened small intestine. A jejunal segment was separated from intestinal continuity in rats. A screw was inserted into its proximal end, and the distal end was oversewn. The screw was advanced into the jejunal segment by 5 mm every other day. The jejunal segments were retrieved after 2 weeks. The length, weight, muscular thickness, alkaline phosphatase, and lactase activities of the jejunal segments were determined. Comparisons were made among normal jejunum, isolated jejunal segments without lengthening, and lengthened jejunal segments. Jejunal segments doubled in length after gradual mechanical stretching compared with the normal and isolated controls. The thickness of the muscular layer increased in both the isolated and lengthened groups. The total activity of alkaline phosphatase increased in jejunal segments that were lengthened, whereas the total lactase activity remained the same. Mechanical force is a viable method for increasing intestinal length while preserving the intestinal function. This phenomenon may provide a new method for the treatment of patients with short bowel syndrome.