Establishment of an immunocompetent nipple valve anastomosis to prevent faecal reflux after ileocolic resection in dogs

Objective: To construct an immunocompetent nipple valve anastomosis (NVA) t o exclude faecal reflux and compare it with an end-to-end anastomosis to se e ii it would prevent recurrent inflammation caused by intraluminal bacteri al antigens in Crohn's disease. Design: Laboratory study. Setting: Teaching hospital, Germany. Animals: Two groups of six beagle dogs each of which had NVA or end-to-end anastomosis. Interventions: Construction of a NVA by stapling the telescoped nipple, and replacing the ileal mucosa on the valve by colonic mucosa; end-to-end anas tomosis. Main outcome measures: Radiological, bacteriological, angiographic, and mor phometric results. Results: Absolute retrograde pressure-competence and free orthograde permea bility of the NVA resulted in significantly lower intestinal bacterial coun ts compared with the end-to-end anastomosis (p < 0.05). Transposition of co lonic mucosa was successful as demonstrated by revascularisation from the i leal nipple and looked normal on morphometry. Conclusion: If NVA were constructed in patients with Crohn's disease, recur rences should be prevented, which would verify the immunopathogenetic hypot hesis of new inflammation.