Mesenteric neovascularization during spring-mediated intestinal lengthening

Background: Short gut syndrome, a condition characterized by inadequate absorption of nutrients owing to decreased bowel length, has minimal avenues for treatment. We have proposed spring-mediated distraction enterogenesis to lengthen bowel in porcine jejunum as a treatment for short gut. We aim to evaluate the extent of mesenteric neovascularization in segments of lengthened bowel via spring-mediated enterogenesis. Methods: Female juvenile Yucatan pigs underwent laparotomy and insertion of gelatin-encapsulated compressed nitinol springs, held in place with plication sutures, into the jejunum. At surgery and sacrifice, macroscopic mesenteric blood vessels were counted between the plication sites. Histologic samples of the mesentery were obtained to evaluate microscopic vasculature. Results: A statistically significant increase in macroscopic mesenteric blood vessels was seen after intestinal lengthening (before: 1.9 +/- 0.7 vessels, after: 4.7 +/- 1.2 vessels, p = 0.001). A statistical significance is also seen in the density of arterioles (control: 3.0 +/- 3.0 vessels/mm, spring: 7.0 +/- 9.0 vessels/mm, p = 0.01) and venules (control: 4.0 +/- 3.0 vessels/mm, spring: 8.0 +/- 8.0 vessels/mm, p = 0.003). Conclusion: Intestinal segments lengthened by intraluminal springs demonstrated total greater number of macroscopic vessels and microscopic blood vessels per length of mesentery as compared to control. This suggests local changes within the mesentery to recruit blood supply to growing intestine. (C) 2020 Elsevier Inc. All rights reserved.

Automated summary

The method of spring-mediated enterogenesis significantly increases the number of blood vessels in porcine jejunum, both macroscopic and microscopic, suggesting local vascular changes to support intestinal growth. This approach may offer a potential treatment option for short gut syndrome with enhanced neovascularization in the lengthened bowel segments.