Progress in intestinal adaptation after enterectomy.
10.3760/cma.j.cn441530-20220510-00208
- VernacularTitle:肠切除术后残余肠道适应现象的研究进展
- Author:
H F SUN
1
;
Q B ZHOU
1
;
W X WANG
2
;
F Q WANG
1
;
Q Q ZHANG
1
;
Z Q SUN
1
;
W T YUAN
1
Author Information
1. Department of Colorectal Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450003, China.
2. Department of Neonatology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
- Publication Type:Review
- MeSH:
Humans;
Adaptation, Physiological;
Glucagon-Like Peptide 2/therapeutic use*;
Intestines/surgery*;
Parenteral Nutrition;
Short Bowel Syndrome/surgery*
- From:
Chinese Journal of Gastrointestinal Surgery
2022;25(12):1132-1137
- CountryChina
- Language:Chinese
-
Abstract:
Intestinal adaptation is a spontaneous compensation of the remanent bowel after extensive enterectomy, which improves the absorption capacity of the remanent bowel to energy, fluid and other nutrients. Intestinal adaptation mainly occurs within 2 years after enterectomy, including morphological changes, hyperfunction and hyperphagia. Intestinal adaptation is the key factor for patients with short bowel syndrome to weaning off parenteral nutrition dependence and mainly influenced by length of remanent bowel, type of surgery and colon continuity. In addition, multiple factors including enteral feeding, glucagon-like peptide 2 (GLP-2), growth hormone, gut microbiota and its metabolites regulate intestinal adaptation via multi-biological pathways, such as proliferation and differentiation of stem cell, apoptosis, angiogenesis, nutrients transport related protein expression, gut endocrine etc. Phase III clinical trials have verified the safety and efficacy of teduglutide (long-acting GLP-2) and somatropin (recombinant human growth hormone) in improving intestinal adaptation, and both have been approved for clinical use. We aim to review the current knowledge about characteristics, mechanism, evaluation methods, key factors, clinical strategies of intestinal adaptation.
