Mechanical distraction enterogenesis utilizing springs has equal effectiveness in adult and juvenile pigs.

Abstract

PURPOSE: We aim to apply our spring-mediated intestinal lengthening technique to adults and children with short bowel syndrome. We hypothesized that spring-mediated intestinal lengthening would be achieved in adult and juvenile pigs. METHODS: Adult and juvenile pigs underwent insertion of a compressed spring into the jejunum. Jejunum was plicated proximal and distal to the capsule for fixation and control jejunum was marked. Pigs were fed a liquid diet for one week. Spring and control segment lengths were compared using Brown-Forsythe and Welch ANOVA test. RESULTS: Three adult pigs weighing 30.4&#x2009;&#xb1;&#x2009;2.1&#xa0;kg and three juvenile pigs weighing 8.9&#x2009;&#xb1;&#x2009;1.2&#xa0;kg underwent spring insertion without complications. Springs were compressed from 7.5 to 2&#xa0;cm and had an average spring constant of 9.7&#x2009;&#xb1;&#x2009;1.2&#xa0;N/m in adults and 5.4&#x2009;&#xb1;&#x2009;1.5&#xa0;N/m in juveniles. Springs of 1.3&#xa0;cm diameter were implanted in adults and springs of 1.0&#xa0;cm diameter were implanted in juveniles. Spring segments lengthened on average by 86&#x2009;&#xb1;&#x2009;33% in adults (p&#x2009;=&#x2009;0.04) and 123% in juveniles (p&#x2009;<&#x2009;0.01) when compared to the initial length. There was no statistically significant difference in lengthening between juvenile and adult pigs (p&#x2009;=&#x2009;0.2). CONCLUSION: Intestinal lengthening was feasible in adult pigs but required a higher force for their larger diameter intestine compared to juvenile pigs.