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Ileocecal Valve Replacement: Its Effect on Transit Time, Survival, and Weight Change After Massive Intestinal Resection

Ileocecal Valve Replacement: Its Effect on Transit Time, Survival, and Weight Change After... Abstract • Sixty-five Sprague-Dawley rats underwent one of three procedures: (1) laparotomy without resection (n = 15); (2) 75% distal small-bowel resection, including the ileocecal valve (n = 25); and (3) 75% bowel resection, including ileocecal valve, and construction of a jejunal valve (n = 25). Rats were evaluated for survival, weight change, and transit time. Mortality was 0% in controls, 84% in group 2, and 28% in group 3 after three months. Rats with resection alone lost 29% of their initial weight, whereas rats with jejunal valves gained 24% over their preoperative weight. Transit time was three times slower in animals with valves. These data suggest that survival, transit time, and weight change are significantly improved in rats with massive bowel resection after construction of an artificial valve when compared with animals with resections alone. These observations imply that, in selected cases, an ileocecal valve replacement may have clinical usefulness. (Arch Surg 1981;116:618-622) References 1. Wilmore DW: Factors correlating with a successful outcome following extensive intestinal resection in newborn infants . J Pediatr 1972;80:88-95.Crossref 2. Mackenzie GW, Borleau GR, St Clair WR: Short gut syndrome: A review with a case report . Can J Surg 1973;16:1-9. 3. Frederick PL, Craig TV: The effect of vagotomy and pyloroplasty on weight loss and survival of dogs after massive intestinal resection . Surgery 1964;56:135-143. 4. Lilly JR, Randolph JG: Effects of vagotomy and pyloroplasty on growth and survival in enterectomized puppies . J Pediatr Surg 1967;3:232-237. 5. Budding J, Smith CC: Role of recirculating loops in the management of massive resection of the small intestine . Surg Gynecol Obstet 1967;125:243-249. 6. Redmond DC, Muraki T, Singleton AO Jr: Effects of recirculating jejunal loops on absorption and transit after massive bowel resection in dogs . Surg Forum 1964;15:291-292. 7. Priebe CJ Jr: Reversed intestinal segments in young puppies with massive intestinal resections . J Pediatr Surg 1970;5:215-223.Crossref 8. Warden MJ, Wesley JR: Small bowel reversal procedure for treatment of the 'short-gut' baby . J Pediatr Surg 1978;13:321-323.Crossref 9. Stahlgren LH, Umana G, Roy R, et al: A study of intestinal absorption in dogs following massive intestinal resection and insertion of an antiperistaltic segment . Ann Surg 1962;156:483-492.Crossref 10. Grosfeld JL, Cooney DR, Jesseph JE: Experimental ileocecal valve replacement in puppies . Surg Forum 1974;25:364-365. 11. Stahlgren LH, Roy R, Umana G: A mechanical impediment to intestinal flow: Physiological effects on intestinal absorption . JAMA 1964;187:141-144.Crossref 12. Cywes S. The surgical management of massive bowel resection . J Pediatr Surg 1968;3:740-748.Crossref 13. Torbey K, Waddell WR: Function of the colon after removal of anal sphincters and replacement by denervated ileal segments . Ann Surg 1961;154:424-431.Crossref 14. Grier RL, Nelson AW, Lumb WV: Experimental sphincter for short-bowel syndrome . Arch Surg 1971;102:203-208.Crossref 15. Schiller WR, DiDio LJ, Anderson MC: Production of artificial sphincters . Arch Surg 1967;95:436-441.Crossref 16. Waddell WR, Kern F, Halgrimson CG: Simple jejunocolic 'valve.' Arch Surg 1970;100:438-443.Crossref 17. Bianchi A: Intestinal loop lengthening: A technique for increasing small intestinal length . J Pediatr Surg 1980;15:145-151.Crossref 18. Benson CD, Lloyd JR, Krabbenhoft KL: The surgical and metabolic aspects of small bowel resection in the newborn . J Pediatr Surg 1967;2:227-240.Crossref 19. Grosfeld JL: Atresia and stenosis of the jejunum and ileum , in Ravitch MM, Welch KJ, Benson CD, et al (eds): Pediatric Surgery , ed 3. Chicago, Year Book Medical Publishers, 1979, pp 933-944. 20. Hidalgo F, Cortes ML, Salas SJ, et al: Intestinal muscular layer ablation in short-bowel syndrome . Arch Surg 1973;106:188-190.Crossref 21. Mall F: Reversal of the intestine . Johns Hopkins Hosp Rep 1896;1:93-101. 22. Zheng HL: An experimental study on the artificial intestinal valve by telescoping anastomosis . Arch Jpn Chir 1977;46:657-680. 23. Satomura K, Kisaka Y, Zheng HL, et al: Intestinal valves by telescoping anastomosis and nontransected muscular valve . Arch Jpn Chir 1979;48:21-32. 24. Ohnishi S: A new artificial valve in the dog: Its comparative function with the intussuscepted conical valve and the mucosal valve . Arch Jpn Chir 1979;48:173-187. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Ileocecal Valve Replacement: Its Effect on Transit Time, Survival, and Weight Change After Massive Intestinal Resection

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References (31)

Publisher
American Medical Association
Copyright
Copyright © 1981 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1981.01380170098018
Publisher site
See Article on Publisher Site

Abstract

Abstract • Sixty-five Sprague-Dawley rats underwent one of three procedures: (1) laparotomy without resection (n = 15); (2) 75% distal small-bowel resection, including the ileocecal valve (n = 25); and (3) 75% bowel resection, including ileocecal valve, and construction of a jejunal valve (n = 25). Rats were evaluated for survival, weight change, and transit time. Mortality was 0% in controls, 84% in group 2, and 28% in group 3 after three months. Rats with resection alone lost 29% of their initial weight, whereas rats with jejunal valves gained 24% over their preoperative weight. Transit time was three times slower in animals with valves. These data suggest that survival, transit time, and weight change are significantly improved in rats with massive bowel resection after construction of an artificial valve when compared with animals with resections alone. These observations imply that, in selected cases, an ileocecal valve replacement may have clinical usefulness. (Arch Surg 1981;116:618-622) References 1. Wilmore DW: Factors correlating with a successful outcome following extensive intestinal resection in newborn infants . J Pediatr 1972;80:88-95.Crossref 2. Mackenzie GW, Borleau GR, St Clair WR: Short gut syndrome: A review with a case report . Can J Surg 1973;16:1-9. 3. Frederick PL, Craig TV: The effect of vagotomy and pyloroplasty on weight loss and survival of dogs after massive intestinal resection . Surgery 1964;56:135-143. 4. Lilly JR, Randolph JG: Effects of vagotomy and pyloroplasty on growth and survival in enterectomized puppies . J Pediatr Surg 1967;3:232-237. 5. Budding J, Smith CC: Role of recirculating loops in the management of massive resection of the small intestine . Surg Gynecol Obstet 1967;125:243-249. 6. Redmond DC, Muraki T, Singleton AO Jr: Effects of recirculating jejunal loops on absorption and transit after massive bowel resection in dogs . Surg Forum 1964;15:291-292. 7. Priebe CJ Jr: Reversed intestinal segments in young puppies with massive intestinal resections . J Pediatr Surg 1970;5:215-223.Crossref 8. Warden MJ, Wesley JR: Small bowel reversal procedure for treatment of the 'short-gut' baby . J Pediatr Surg 1978;13:321-323.Crossref 9. Stahlgren LH, Umana G, Roy R, et al: A study of intestinal absorption in dogs following massive intestinal resection and insertion of an antiperistaltic segment . Ann Surg 1962;156:483-492.Crossref 10. Grosfeld JL, Cooney DR, Jesseph JE: Experimental ileocecal valve replacement in puppies . Surg Forum 1974;25:364-365. 11. Stahlgren LH, Roy R, Umana G: A mechanical impediment to intestinal flow: Physiological effects on intestinal absorption . JAMA 1964;187:141-144.Crossref 12. Cywes S. The surgical management of massive bowel resection . J Pediatr Surg 1968;3:740-748.Crossref 13. Torbey K, Waddell WR: Function of the colon after removal of anal sphincters and replacement by denervated ileal segments . Ann Surg 1961;154:424-431.Crossref 14. Grier RL, Nelson AW, Lumb WV: Experimental sphincter for short-bowel syndrome . Arch Surg 1971;102:203-208.Crossref 15. Schiller WR, DiDio LJ, Anderson MC: Production of artificial sphincters . Arch Surg 1967;95:436-441.Crossref 16. Waddell WR, Kern F, Halgrimson CG: Simple jejunocolic 'valve.' Arch Surg 1970;100:438-443.Crossref 17. Bianchi A: Intestinal loop lengthening: A technique for increasing small intestinal length . J Pediatr Surg 1980;15:145-151.Crossref 18. Benson CD, Lloyd JR, Krabbenhoft KL: The surgical and metabolic aspects of small bowel resection in the newborn . J Pediatr Surg 1967;2:227-240.Crossref 19. Grosfeld JL: Atresia and stenosis of the jejunum and ileum , in Ravitch MM, Welch KJ, Benson CD, et al (eds): Pediatric Surgery , ed 3. Chicago, Year Book Medical Publishers, 1979, pp 933-944. 20. Hidalgo F, Cortes ML, Salas SJ, et al: Intestinal muscular layer ablation in short-bowel syndrome . Arch Surg 1973;106:188-190.Crossref 21. Mall F: Reversal of the intestine . Johns Hopkins Hosp Rep 1896;1:93-101. 22. Zheng HL: An experimental study on the artificial intestinal valve by telescoping anastomosis . Arch Jpn Chir 1977;46:657-680. 23. Satomura K, Kisaka Y, Zheng HL, et al: Intestinal valves by telescoping anastomosis and nontransected muscular valve . Arch Jpn Chir 1979;48:21-32. 24. Ohnishi S: A new artificial valve in the dog: Its comparative function with the intussuscepted conical valve and the mucosal valve . Arch Jpn Chir 1979;48:173-187.

Journal

Archives of SurgeryAmerican Medical Association

Published: May 1, 1981

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