Reversed bowel segments for the treatment of short bowel syndrome: assessment of their minimal length in correlation with electromyographic pattern in the rat

Reversal of a distal intestinal loop is a surgical therapy intended to cure rapid intestinal transit in short bowel syndrome. To be active, a reversed loop must present a retrograde propagation of electromyographic patterns a nd must not be so long as to cause total obstruction. The aim of the curren t study was to propose methods to calculate the minimal length of the intes tinal reversed loop taking into consideration the two previous conditions. Intestinal electromyograms were recorded in 65 rats at shortterm (4 days af ter surgery) and ten rats at long-term (50 days after surgery). Control rat s demonstrated that the preprandial regular spiking activity (RSA) of the m igrating myoelectrical complex (MMC) extended simultaneously a definite par t of the intestine which corresponds to the minimal length to reverse. A si milar result can be obtained from a trigonometric representation. Whatever the method, the minimal lengths allowing the recording of RSA decreased alo ng the rat intestine from 6 cm (proximal jejunum) to 4 cm (distal ileum). T he experiments demonstrated that shorter loops did not present the preprand ial RSA. In conclusion, the minimal reversed length depends on intestinal e lectromyographic parameters and, thereby, on the intestinal level.