Restoration of mechanically lengthened jejunum into intestinal continuity in rats.

Prior studies demonstrated the feasibility of lengthening intestinal segments with mechanical force, but no previous studies have restored the lengthened segment back into intestinal continuity. A 1-cm segment of isolated rat jejunum was lengthened using a Nitinol spring. After lengthening, this segment was restored into intestinal continuity via a transection of the intact small intestine. Rats were euthanized 2 weeks later to retrieve the restored intestinal segment for histologic and enzymatic analyses. The isolated jejunal segments were initially lengthened to 3.3 ± 0.9 cm. After the lengthened segments were restored into intestinal continuity for 2 weeks, the final length of the restored segment was 1.9 ± 0.7 cm. All rats continued to gain weight, and the intestine proximal to the restored jejunal segment remained normal 2 weeks later. The restored jejunal segment had an increase in crypt depth and no difference in villus height compared with normal jejunum. Sucrase activity in the restored segment was not different from that in normal jejunum. Mechanically lengthened jejunum can be restored into intestinal continuity and appears to have normal function. This further demonstrates the feasibility of mechanical enterogenesis as a potential therapy for short bowel syndrome.