Can a Small Intestine Segment Be an Alternative Biological Conduit for Peripheral Nerve Regeneration?
Journal Title: Balkan Medical Journal - Year 2017, Vol 34, Issue 3
Abstract
Background: Autologous nerve grafts are used to bridge peripheral nerve defects. Limited sources and donor site morbidity are the major problems with peripheral nerve grafts. Although various types of autologous grafts such as arteries, veins and muscles have been recommended, an ideal conduit has not yet been described. Aims: To investigate the effectiveness of a small intestinal conduit for peripheral nerve defects. Study Design: Animal experimentation. Methods: Twenty-one rats were divided into three groups (n=7). Following anaesthesia, sciatic nerve exploration was performed in the Sham group. The 10 mm nerve gap was bridged with a 15 mm ileal segment in the small intestinal conduit group and the defect was replaced with orthotopic nerve in autologous nerve graft group. The functional recovery was tested monthly by walking-track analysis and the sciatic functional index. Histological evaluation was performed on the 12th week. Results: Sciatic functional index tests are better in autologous nerve graft group (-55.09±6.35); however, during follow-up, progress in sciatic functional index was demonstrated, along with axonal regeneration and innervation of target muscles in the small intestinal conduit group (-76.36±12.08) (p<0.05). In histologic sections, distinctive sciatic nerve regeneration was examined in the small intestinal conduit group. The expression of S-100 and neurofilament was observed in small intestinal conduit group but was less organised than in the autologous nerve graft group. Although the counted number (7459.79±1833.50 vs. 4226.51±1063.06 mm2), measured diameter [2.19 (2.15-2.88) vs. 1.74 (1.50-2.09) µm] and myelin sheath thickness [1.18 (1.09-1.44) vs. 0.66 (0.40-1.07) µm] of axons is significantly high in the middle sections of autologous nerve graft compared to the small intestinal conduit group, respectively (p<0.05), the peripheral nerve regeneration was also observed in the small intestinal conduit group. Conclusion: Small intestinal conduit should not be considered as an alternative to autologous nerve grafts in its current form; however, the results are promising. Even though the results are no better than autologous nerve grafts, with additional procedures, it might be a good alternative due to harvesting abundant sources without donor site morbidity.
Authors and Affiliations
Mehmet S. Arda, Emre A. Koçman, Emre Özkara, Erdem Söztutar, Orhan Özatik, Aydan Köse, Cengiz Çetin
Keywords
Related Articles
- EP ID EP380462
- DOI 10.4274/balkanmedj.2015.1601
- Views 56
- Downloads 0
Alveolar Bone Density Reduction in Rats Caused by Unilateral Nasal Obstruction
Background: Oral breathing can cause morphological changes in the oral and maxillofacial regions. Aims: To investigate whether oral breathing affected structural changes in bone tissues. Study Design: Animal experimentat...
Association Between the Inflammatory Biomarkers and Left Ventricular Systolic Dysfunction in Patients with Exacerbations of Chronic Obstructive Pulmonary Disease
Background: Cardiovascular diseases are an important cause of morbidity and mortality in chronic obstructive pulmonary disease patients. The increased inflammatory biomarker levels predict exacerbations and are associate...
The Effect of Chemerin on Cardiac Parameters and Gene Expressions in Isolated Perfused Rat Heart
Background: Chemerin is a novel chemoattractant adipokine expressed in cardiovascular system, and its receptor has been detected in the epicardial adipose tissue. Aims: To determine the effects of chemerin on the cardiac...
Changing Trends in Gastric Cancer Surgery
Gastric cancer is one of the most common causes of cancer-related death. It requires multimodal treatment and surgery is the most effective treatment modality. Radical surgery includes total or subtotal gastrectomy with...
Association Between Erosive Esophagitis and the Anthropometric Index in the General Korean Population
Background: An association between obesity and gastroesophageal reflux disease has been reported. However, previous studies have focused on obesity or central obesity. Aims: To investigate the association of the anthropo...