Modified paul-mikulicz ileostomy in a swine model of isolated small bowel transplantation
Journal
Journal of Surgical Research
Journal Volume
164
Journal Issue
2
Pages
329-335
Date Issued
2010
Author(s)
Tsai M.-S.
Chen W.-J.
Abstract
Background: Intestinal transplantation (ITx) is a life-saving procedure for patients with intestinal failure. The poorer outcome of ITx than of other organ transplantation, however, warrants more clinical and basic research on ITx. Herein, we developed a modified Paul-Mikulicz ileostomy procedure in a swine model of ITx, and investigated its feasibility for obtaining intestinal samples of both the graft and the recipient. Materials and Methods: We performed ITx in 10 pairs of piglets, each weighing 15-20kg. Procurement included an isolated segment of the small bowel, constituting a model of a living, related donor surgery. The recipient procedures included end-to-end anastomosis of vascular stumps, a proximal jejuno-jejunal anastomosis, and a distal modified Paul-Mikulicz ileostomy. The procedure differed from the classic Paul-Mikulicz ileostomy in that a common channel was created in a side-to-side fashion. Results: Vascular thrombosis occurred in three pigs, resulting in immediate loss of the graft. All other pigs underwent ITx successfully and survived for at least 1 wk (7-180 d). No pig experienced anastomotic leaks, ileus, or stoma-related complications. Moreover, this technique enabled us to obtain tissue samples of both the graft and the native ileum without disturbing the natural bowel conduit. Conclusions: The modified Paul-Mikulicz ileostomy was feasible in a swine model of ITx. It facilitated the collection of intestinal samples of both the graft and the recipient. ? 2010 Elsevier Inc. All rights reserved.
SDGs
Other Subjects
cefmetazole; methylprednisolone; tacrolimus; animal experiment; animal tissue; article; continuous infusion; controlled study; end to end anastomosis; graft failure; graft survival; ileostomy; ileum; intestine transplantation; male; nonhuman; priority journal; surgical technique; swine; thrombosis; Animals; Body Weight; Humans; Ileostomy; Immunosuppressive Agents; Intestinal Diseases; Intestine, Small; Living Donors; Male; Mesenteric Arteries; Mesenteric Veins; Parenteral Nutrition; Postoperative Period; Reperfusion; Swine; Tacrolimus; Transplantation, Homologous
Type
journal article