SHORT GUT SYNDROME - TREATMENT BY NEOVASCULARIZATION OF THE SMALL-INTESTINE

Surgical treatment for short bowel syndrome has been directed toward s lowing intestinal transit or increasing the absorptive surface area of the bowel. In the present work, we attempted to enhance bowel absorpt ion by increasing vascularity, using the omentum's unique ability to r evascularize incorporated tissue. After a 90% resection of small bower with primary anastomosis in 5 mongrel dogs, an omental flap based on the right gastroepiploic vessels was incorporated into a seromuscular incision on the antimesenteric border of the remnant small bowel. Five control dogs underwent a similar resection and seromuscular incision with an omentectomy. Serum d-xylose assays, hemoglobin, and total prot ein levels were measured preoperatively and at 3, 6, 9, and 12 weeks p ostoperatively. Weekly weights were followed. The mean percent d-xylos e absorption in the experimental group increased from 96% of the basel ine at 3 weeks to 136%, 163%, and 179% at 6, 9, and 12 weeks respectiv ely (p < 0.5). The control group maintained absorption levels between 54% and 74%. Weight loss in the experimental group was significantly l ess than the controls at weeks 6 and 9, but by 12 weeks, weights were similar for the two groups. Small bowel absorption of d-xylose was sig nificantly enhanced by incorporation of the omentum into the bowel rem nant.