Effects of succus entericus reinfusion with continuous enteral nutrition on the barrier function of intestinal mucosa in patients with stomal type fistulas
ZHU Jin-guo, YU Ren, GE Heng-fa, JIANG Bao-fei, TAO Guo-quan
Published 2011-08-30
Cite as , 2011,19(04): 239-241. DOI: 10.3760/cma.j.issn.1674-635x.2011.04.006
Abstract
Objective To observe the effect of succus entericus reinfusion with continuous enteral nutrition on the barrier function of intestinal mucosa and nutritional status in patients with stomal type fistulas. Methods Sixteen patients with stomal type fistula from July 1995 to May 2008 were enrolled in the study. A]l patients met the following conditions: gut function returned normal; abdominal infection was controlled; total enteral nutrition was provided ; and the length of small intestine for succus entericus reinfusion was more than 50 cm. Intestinal mucosa was taken at 25 to 30 cm away from stoma of fistula by endoscope 0, 7, and 14 days after reinfusior. Hematoxylineosin staining was performed to count the number of intestinal intraepithelial lymphocytes (IIELS). In addition,proliferating cell nuclear antigen (PCNA) was measured with immunohistochemical staining. Serum protein levels were determined by immunonephelometry. Results The percentage of IIELS in intestinal mucosa ( 19.06% ±4.81% vs. 12.81% ±2.95%, P=0.000) and the percentage of PCNA positive cells ( 12.13% ±4.33% vs.6.44% ± 2.34%, P =0.000) 14 days after succus entericus reinfusion were significantly higher than those on the day of reinfusion. Serum fibronectin level increased from ( 152.80 ± 16.50 ) to ( 227.05 ± 45.36 ) mg/L ( P =0.000), and transferring protein level increased from ( 2.16 ± 0.52 ) to ( 2.62 ± 0.41 ) g/L ( P =0.017 ) 14days after succus entericus reinfusion. Conclusion Succus entericus reinfusion is effective in protecting the intestinal mucosa in patients with stomal type fistulas.
Key words:
Succus entericus reinfusion; Stomal type fistula; Intestinal intraepithellal lymphocytes; Proliferating cell nuclear antigen
Contributor Information
ZHU Jin-guo
Department of General Surgery, the First People's Hospital of Huai'an City, Huai'an, 223300, China
YU Ren
Department of General Surgery, the First People's Hospital of Huai'an City, Huai'an, 223300, China
GE Heng-fa
Department of General Surgery, the First People's Hospital of Huai'an City, Huai'an, 223300, China
JIANG Bao-fei
Department of General Surgery, the First People's Hospital of Huai'an City, Huai'an, 223300, China
TAO Guo-quan
Department of General Surgery, the First People's Hospital of Huai'an City, Huai'an, 223300, China