Time‐ and Segment‐related Changes of Postresected Intestine

Buccigrossi, Vittoria; Armellino, C.; Tozzi, Arturo; Nicastro, Emanuele; Esposito, Ciro; Alicchio, Francesca; Cozzolino, Santolo; Guarino, Alfredo

doi:10.1097/mpg.0b013e318268a9a4

Cited by 11 publications

(5 citation statements)

References 39 publications

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“…On a similar note, a 30-day post-resection observation period may have been inadequate to observe differential effects of intestinal adaptation that can occur after massive intestinal resection 18 . There was some evidence of adaptation in terms of both villus height and thickness of muscularis externa that occurred in the enterectomy groups relative to the sham groups, but these differences were relatively small, and an effect of obesity was not obvious.…”

Section: Discussionmentioning

confidence: 99%

Effect of proximal versus distal 50% enterectomy on nutritional parameters in rats preconditioned with a high-fat diet or regular chow

Yanala

Reidelberger

Thompson

et al. 2015

Sci Rep

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Obesity may protect against the nutritional consequences of short bowel syndrome. We hypothesized that rats preconditioned with an obesogenic diet would have better outcomes after surgical induction of short bowel syndrome compared to rats on regular chow. Rats were fed a high-fat diet or regular rat chow for six months, and then underwent 50% proximal, 50% distal, or sham enterectomy. Food intake, weight, and body composition were monitored before and for 4 weeks after surgery. The high-fat diet consistently produced obesity (>25% body fat). All procedures induced weight loss, but there was no discernable difference between resection vs. sham resection. Rats on the high-fat diet had a greater post-resection loss of body fat compared to rats on chow (36 vs. 26 g, respectively). There was a nonsignificant trend of less lean mass loss in the former compared to the latter rats (16 vs. 33 g, respectively). Enterectomy moderated serum ghrelin, GIP, PPY, insulin, and leptin. Intestinal adaptation was not different between obese vs. non-obese rats. Rats preconditioned with the high-fat diet may have had better retention of lean body mass after a surgical procedure compared to rats on chow. The effect of 50% enterectomy was less than expected.

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Section: Discussionmentioning

confidence: 99%

Effect of proximal versus distal 50% enterectomy on nutritional parameters in rats preconditioned with a high-fat diet or regular chow

Yanala

Reidelberger

Thompson

et al. 2015

Sci Rep

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“…Enteral nutrition (EN) is considered an important tool for the prevention or reversal of IFALD. It decreases the rate of the intestinal adaptation promoting the complex set of time- and segment-specific compensatory changes that maintain the bowel absorptive function (i.e., the increase in small intestinal mucosal thickness, villus length, crypt depth) [ 38 ], ultimately decreasing the requirements of PN. Moreover, EN does not favor bacterial overgrowth [ 32 ].…”

Section: Risk Factors For Ifald Developmentmentioning

confidence: 99%

Prevention and Treatment of Intestinal Failure-Associated Liver Disease in Children

et al. 2018

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Intestinal failure-associated liver disease (IFALD) is a threatening complication for children on long-term parenteral nutrition because of intestinal failure. When progressive and intractable, it may jeopardize intestinal rehabilitation and lead to combined liver and intestinal transplantation. The institution of dedicated intestinal failure centers has dramatically decreased the incidence of such complication. IFALD may rapidly fade away if very early management aimed at preventing progression to end-stage liver disease is provided. In this review, we address the etiology and risk factors of IFALD in order to introduce pillars of prevention (nutritional management and catheter-related infections control). The latest evidence of therapeutic strategies, such as medical and surgical treatments, is also discussed.

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“…Chronic diarrhea, steatorrhea, fluid-electrolyte imbalances and macronutrient and micronutrient deficiencies, often requiring enteral and/or parenteral nutrition support at home, frequently complicate its course [3 & ]. Following massive intestinal resection, a process of intestinal adaptation occurs in which the remaining bowel undergoes macroscopic and microscopic morphologic and functional changes in response to a variety of internal and external stimuli including nutrients, gastrointestinal secretions, hormones, growth factors and other genetic/biochemical factors in order to increase its absorptive ability [4]. Intestinal adaptation is highly variable, unique to each individual and usually occurs during the first 2 years following massive intestinal resection in adults; longer and perhaps more vigorously in children.…”

Section: Short Bowel Syndromementioning

confidence: 99%

Short bowel syndrome and small bowel transplantation

DiBaise

2014

Current Opinion in Gastroenterology

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Recently available trophic factors hold promise as aids in restoring freedom from parenteral nutrition support; however, their long-term benefits, preferred timing of administration in relation to the onset of SBS, optimal patient selection for use, duration of treatment and cost effectiveness require further study. Despite recent evidence of improved early survival after SBT, more dedicated research is needed to design more effective strategies to better tolerize small bowel grafts, prevent rejection and, ultimately, improve long-term outcomes. Reserved for well selected patients, autologous gastrointestinal reconstruction should be considered complementary and not antagonistic to SBT.

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Time‐ and Segment‐related Changes of Postresected Intestine

Cited by 11 publications

References 39 publications

Effect of proximal versus distal 50% enterectomy on nutritional parameters in rats preconditioned with a high-fat diet or regular chow

Effect of proximal versus distal 50% enterectomy on nutritional parameters in rats preconditioned with a high-fat diet or regular chow

Prevention and Treatment of Intestinal Failure-Associated Liver Disease in Children

Short bowel syndrome and small bowel transplantation

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