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J Reconstr Microsurg 2017; 33(09): 605-611
DOI: 10.1055/s-0037-1603905
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Early Markers of Angiogenesis and Ischemia during Bowel Conduit Neovascularization

Oscar J. Manrique
1   Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota
,
Pedro Ciudad
2   Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan
,
Alex Wong
3   Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
,
Federico Lo Torto
2   Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan
,
Yun-Fen Li
4   Institute of Biostatistics, China Medical University Hospital, Taichung, Taiwan
,
Pei-Yu Chen
5   Department of Pathology, China Medical University Hospital, Taichung, Taiwan
,
Doan-Minh Nguyen
1   Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota
,
Hung-Chi Chen
2   Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan
› Author Affiliations
Further Information

Publication History

10 February 2017

10 May 2017

Publication Date:
19 June 2017 (online)

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Abstract

Background Bowel flaps are a good and reliable method to restore the continuity of the aerodigestive tract. Radiated fields, contaminated recipient sites, or depleted recipient vessels may increase the risk for ischemic injury after transfer. During ischemic events, we believe that bowel conduits with serosa have a delayed neovascularization process at its new recipient site.

We conducted an ischemia/reperfusion murine model to understand the difference among bowel conduits with and without serosa.

Materials and Methods Two groups of rats were compared: control group (jejunal conduit with serosa) and a target group (jejunal conduit without serosa). These conduits were harvested from the peritoneal cavity and transferred into a subcutaneous pocket. After 72 hours of transfer and pedicle ligation, histological changes related to ischemia/reperfusion were assessed. In addition, tissue markers of angiogenesis (CD34), ischemia (lactate dehydrogenase [LDH]), and inflammation (interleukin [IL]-1β and IL-6) were analyzed.

Results Two groups (n = 20) of male rats were analyzed. Histology showed intact jejunal mucosa in the target group. The control group showed decreased number of mucin, globet cells, decreased height, and fragmentation of villi with the absence of intestinal glands. Markers of angiogenesis (CD34) were higher in the target group. In addition, markers of ischemia (LDH) (p = 0.0045) and inflammation (IL-1b, p = 0.0008, and IL-6, p = 0.0008) were significantly lower in the target group as compared with the control group.

Conclusions In circumstances in which the recipient site does not offer an adequate and healthy bed or a vascular insult occurs, bowel flaps with less amount of serosa may be able to neovascularize faster thereby increasing its chances of survival.

Keywords

microsurgery - bowel conduits - neovascularization

Note

This paper was presented at the American Society of Reconstructive Microsurgery, Waikoloa, HI, 2017.


 

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