ESTIMATION OF SOME SURGICAL MANAGEMENT FOR SHORT BOWEL SYNDROME

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Schiller, DiDio and Anderson reported that removal of 1 cm segments of longitudinal muscle coat in small intestine produced a sphincter-like action and delayed the transit time. To verify their report, the author performed 90% massivebowel resections in 35 mongrel dogs. In 10 dogs out of 35, reversed jejunalsegments, 10 cm in length, were interposed. In 9 dogs, circumferential removal of 1 cm strip of longitudinal muscle coat was performed proximal to the jejunoileal anastomosis according to the Anderson's technique. In 8 dogs, two of these "artificial sphincters" were situated 5 cm proximal to the jejunoileal anastomosis. In the remaining 8 dogs, no attempt was made surgically to delay the transit time. The longest survival time in animals with reversed jejunal segments was 9 months. Five animals out of 9 with circumferential removal of 1 cm strip of longitudinal muscle coat survived for more than two years and 3 control dogs survived over two years. It was found that the attempt to delay transit time of the bowel by producing the Anderson's stripped area was unsatisfactory, and that, at the present time, no definite operative measure is available to control short bowel syndrome.
日本平滑筋学会の論文