|
Back to 2016 Annual Meeting
Nutritional Evaluation in Pigs Submitted to a Serial Transversal Enteroplasty (STEP)
Alexandre bakonyi*, Bonifácio K. Takegawa, Pedro L. Lourenção, Erika P. Ortolan, Rozemeire Marques
Surgery, Botucatu School of Medicine, Botucatu, Sao Paulo, Brazil
Background: STEP is a surgical therapy for short bowel syndrome and is being used with increasing frequency. Most reports demonstrated the efficacy of the procedure when realized over a remaining dilated intestine. The aim of this study was to evaluate the outcome of pigs submitted to Step immediately after an extensive intestinal resections (on non-dilated remaining bowel) and when realized on dilated bowel, induced by reversed segments followed by resection.
Methods: Large-white Landrace pigs (n=15) were distributed in 3 groups: G1 was submitted to resection of 95% small bowel; G2 had a reversed segment of bowel interposed to induce dilatation, followed after 6 weeks by 95% intestinal resection and STEP procedure on remaining dilated bowel and G3 to a 95% intestine resection plus STEP on non-dilated remaining bowel. Determinations of nutritional status ( body weight, albumin and triglyceride levels ) were obtained for 14 weeks period and intestinal bacterial content at the end of study.
Results: G1 animals loosed 27% of body weight, associated to a decrease of triglyceride levels ( 20%) and were sacrificed after 8 weeks.G2 animals showed improved weight gain (8%) and G3 animals loosed 10% of body weight, statistically significant when compared to controls (p<0.05), booths associated to an increased fat absorptive capacity measured by triglyceride levels. All groups demonstrated a decrease in albumin levels (+/- 18%). Aerobic and anaerobic bacterial distribution was similar between groups, without bacterial overgrowth.
Conclusion: The STEP procedure improved weight retention and nutritional status after 95% bowel resections. The lesser weight loss on G2 animals when compared to controls also support the concept that the step procedure can be safely done immediately after resection on non-dilated remaining bowel.
Comparison of the absolute difference weight, triglyceride levels and albumin between groups.
| | No Resection
(n=5) | 95% Resection
(n=7) | Step after 6 weeks
(n=3) | Imediate Step
(n=4) | p | | Variable | Pré - Pós | Pré - Pós | Pré - Pós | Pré - Pós | | | weight (KG) | 28 - 57 | 36 - 20 | 27 - 23 | 28 - 23 | 0,047 | | Triglyceride (mg/dL) | 91 - 25 | 38 - 41 | 60 - 80 | 59 - 68 | 0,889 | | Albumin | 3 - 3 | 3 - 3 | 3 - 2 | 3 - 2 | 0,08 |
Back to 2016 Annual Meeting
|
