Significance of the Extent of Intestinal Resection on the Outcome of a Short-bowel Syndrome in a Porcine Model

J Invest Surg. 2016;29(1):57-65. doi: 10.3109/08941939.2015.1057304. Epub 2015 Sep 16.

Abstract

Aim of the study: 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.

Keywords: intestinal failure; intestinal resection; porcine model.; resection extent; short-bowel syndrome; swine model.

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Citrulline / blood
  • Diarrhea / blood
  • Diarrhea / etiology
  • Disease Models, Animal*
  • Electrolytes / blood
  • Female
  • Intestinal Mucosa / pathology*
  • Intestine, Small / blood supply
  • Intestine, Small / surgery*
  • Prealbumin / analysis
  • Serum Albumin / analysis
  • Short Bowel Syndrome*
  • Sus scrofa*
  • Transferrin / analysis
  • Weight Loss

Substances

  • Electrolytes
  • Prealbumin
  • Serum Albumin
  • Transferrin
  • Citrulline