Premium
Roux‐en‐Y or ‘uncut’ Roux procedure? Relation of intestinal migrating motor complex recovery to the preservation of the network of interstitial cells of Cajal in pigs
Author(s) -
Kiciak Adam,
Woliñski Jarosław,
Borycka Katarzyna,
Zabielski Romuald,
Bielecki Krzysztof
Publication year - 2007
Publication title -
experimental physiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.925
H-Index - 101
eISSN - 1469-445X
pISSN - 0958-0670
DOI - 10.1113/expphysiol.2006.035253
Subject(s) - interstitial cell of cajal , jejunum , roux en y anastomosis , medicine , surgery , plexus , electromyography , anatomy , immunohistochemistry , weight loss , gastric bypass , physical medicine and rehabilitation , obesity
We designed a conscious pig model to investigate myoelectric activity and the number of interstitial cells of Cajal (ICC) in the proximal jejunum following the Roux‐en‐Y and ‘uncut’ Roux procedures in relation to clinical outcomes. Twelve male Polish White pigs (8 weeks old, 10–13 kg) underwent surgery under general anaesthesia first to implant bipolar electrodes and telemetry transmitters for continuous electromyography recordings and then, after 1 week recovery, to create Roux‐en‐Y ( n = 6) and ‘uncut’ Roux loops ( n = 6). Upper gut tissue specimens were studied for the expression of c‐kit staining procedure to quantitatively identify the presence of interstitial cells of Cajal. The intestinal migrating motor complex was restored within 10.5 and 37 h in ‘uncut’ Roux and Roux‐en‐Y pigs, respectively ( P < 0.05). During 2 weeks, the ‘uncut’ Roux piglets increased their body weight by 18.0%, whereas the Roux‐en‐Y piglets increased their body weight by only 7.3% ( P ≤ 0.05). Two weeks after surgery, the number of ICC located in the region of Auerbach's plexus was higher and adhesions in the abdominal cavity lower in the ‘uncut’ Roux group. In conclusion, in the pig model, preservation of smooth muscle and ICC network continuity in the proximal jejunum may play an important role in early postsurgical recovery.