Viability of a jejunal segment after neovascularization by omentoenteropexy

Abstract

Omentoenteropexy was developed as an alternative technique to promote neovascularization in an isolated bowel segment. OBJECTIVE: The aim of the present protocol was to study the long-term viability of an isolated jejunal segment following neovascularization by omentoenteropexy. Long-term survival of a neovascularized bowel segment is an indication that the utilization of this segment as an intestinal graft can be successful. METHODS: To test the proposed surgical technique, 13 Wistar rats were subjected to laparotomy, the jejunum was exposed at 20 cm from the angle of Treitz and a pedicle of greater omentum was isolated. An incision of 6 cm was made along the antimesenteric jejunal border, exposing the submucosa. Omentoenteropexy was performed between the incision of the jejunum and the pedicle of the greater omentum. After seven weeks, the mesentery of the jejunal segment subjected to omentoenteropexy was ligated and isolated from the rest of the jejunum by a complete proximal and distal transversal section. Subsequently, an end-to-end anastomosis was performed to restore the continuity of the bowel. RESULTS: At 10 weeks from the first surgical intervention, the isolated jejunal segment subjected to omentoenteropexy was completely neovascularized and viable. CONCLUSION: No evidence of anatomical or functional intestinal obstruction was observed.

Enteric nervous system with chronic mesenteric ischemia: experimental study

“…В ряде случаев было отмечено спонтанное подпаивание сальника к стенке кишки. Как известно, оментопексия (подшивание сальника) широко используют в различных областях хирургии, учитывая высокую способность его тканей к ангиогенезу [22][23][24]. Неоваскуляризация стенки кишки через сальник может предотвратить некроз сегмента с нарушенным кровотоком, однако поддерживающего кровотока недостаточно для интрамуральных нервных клеток.…”

A morphometric study of the intestinal mucosa of rats submitted to omentoenteropexy

“…These authors suggested the use of an alternative organ, the greater omentum, for neovascularization of an isolated segment of intestine, raising the possible limitations of the former models that had been proposed, which used abdominal muscles or liver for that purpose (11) . Rocha et al (8) published the first omentoenteropexy study in a non-isolated jejunal segment, which consisted of an omentoenteropexy 6 centimeters long, held in a jejunal segment 20 centimeters distal to the duodenum -jejunal angle. Seven weeks after the procedure, this segment had its mesenteric vasculature ligated, and a Departamento de Cirurgia, Patologia e Gastroenterologia Pediátrica -Faculdade de Medicina do ABC, Santo André, SP, Brasil.…”