We would like to acknowledge the funding contributions of the Canadian Surgical Research Fund, the Edmonton Civic Employees Research Assistance Fund, and the Alberta IBD Consortium through a grant from Alberta Innovates.

Protocolli di uso animale sono stati approvati dal comitato Health Science cura degli animali e l&#39;uso presso l&#39;Università di Alberta. 1. Preparazione degli strumenti, Animali e Setup Operativo <ol><li> Trasferire animali ad una nuova, pulita gabbia assente di tutto solido cibo 24 ore prima della procedura. Essi possono avere libero accesso all&#39;acqua e dieta liquida ad lib fino al momento della procedura. </li><li> Autoclavare tutti gli strumenti necessari per la procedura. Superficie operativo pulito e anestetico cono con il 70% di etanolo. </li><li> Impostare la superficie operativa con il microscopio operatorio, macchina anestetica e forniture in un modo che è comodo per il chirurgo. I gomiti del chirurgo dovrebbe essere permesso di riposare comodamente sul tavolo operatorio, con le mani e le braccia non ostruite dalle attrezzature. Strumenti, suture, tamponi di cotone, e una siringa da 10 ml devono essere collocati in una posizione che consenta un facile accesso durante la procedura. </li><li> Impostarelampade di calore aeree per fornire sia calore per l&#39;animale durante la procedura e la luce per la superficie operativa. </li><li> Riempire un tubo da 50 ml con soluzione fisiologica 0,9%, e una provetta da 1,5 ml con vaselina e posto vicino alla superficie operativa. NOTA: Sterilizzare tutti gli strumenti e le forniture chirurgiche. Poiché l&#39;intestino viene sezionato, la procedura stessa non è sterile. E &#39;considerata pulita-contaminata. Adottare misure per evitare l&#39;introduzione di fonti esogene di infezione. </li></ol> 2. ileocolica resezione con anastomosi <ol><li> Indurre l&#39;anestesia con la somministrazione di 4% isoflurano con un tasso di flusso di ossigeno di 2 L / min con cono dal vaporizzatore isoflurano fino a quando la frequenza respiratoria animali rallenta a circa 30-40 atti / min. Applicare una pressione moderata per il piede posteriore del mouse per garantire che non vi è alcuna risposta al dolore prima di iniziare la procedura. A questo punto, abbassare isoflurano al 2% e il flusso di ossigeno di 0,5 l / min. Intermittentecontrollare la risposta al dolore durante la procedura e regolare flusso isoflurano conseguenza. </li><li> Applicare vaselina per gli occhi contro l&#39;essiccamento durante l&#39;intervento chirurgico, e immobilizzare il mouse nella posizione supina con gli arti fissati con del nastro trasparente. </li><li> Pulire l&#39;addome con la soluzione povodine / di iodio, e cambiare in nuovi guanti sterili. </li><li> Fare un incisione cutanea 1,5 centimetri sulla linea mediana superiore dell&#39;addome con punta acuminata dissezione forbici per esporre la fascia e del peritoneo. Aprire lo strato fasciale / peritoneale in modo simile attraverso la linea alba per esporre il contenuto peritoneale. </li><li> In contrasto con gli esseri umani, il cieco del mouse si trova in genere nel quadrante superiore sinistro dell&#39;addome. Una volta identificato, afferrare delicatamente il cieco con una pinza e consegnarlo attraverso l&#39;incisione. Usare tamponi di cotone inumiditi a ventaglio di circa 3 cm di ileo terminale estende dal cieco su una garza sterile drappeggiato sulla superficie addominale (Figura 1A).Assicurarsi che l&#39;intestino esposto è tenuto umido con 0,9% di soluzione salina durante l&#39;interezza della procedura. </li><li> Identificare l&#39;arteria ileocecale dirama l&#39;arteria mesenterica superiore lungo il colon (Figura 1A) utilizzando il microscopio operatorio. Sezionare i tessuti avascolari adiacenti all&#39;arteria ileocecale, circondare e legare l&#39;arteria con una cravatta di seta 5-0. Quindi, individuare l&#39;apporto di sangue regionale per l&#39;ileo terminale e scegliere un punto transection 1,5-2 cm prossimalmente alla giunzione ileocecale. Legare i rami a questa sezione di ileo come sopra. Dividere le arterie con micro dissezione forbici. </li><li> Dividere le porzioni ischemici di ileo e del colon di assicurare un adeguato apporto di sangue alle estremità sezionati (Figura 1B). È spesso utile spatolate ileo dividendolo con un angolo di 30 gradi per aumentare il diametro del lume modo che corrisponde più strettamente il colon. Una volta che la porzione di intestino ileocecale è stato rimosso, allineare laestremità sezionati di ileo e del colon sulla garza, assicurando i confini di ogni mesenterici sono allineati. </li><li> Costruire l&#39;anastomosi approssimando la fine transected dell&#39;ileo alla fine transected del colon mediante interrotto 8-0 suture in polipropilene (Figura 1C). Il primo punto è posto al confine mesenterica, con suture successive poste ogni 0,5 mm, fino anastomosi ileocolica è a tenuta stagna. Quando si passa l&#39;ago di sutura attraverso l&#39;ileo e colon, in modo che il bordo tagliato non viene arrotolata, e morsi di aghi sono mm 0,5 dai bordi tagliati dell&#39;intestino. Una anastomosi tipico richiede da 14 a 16 punti staccati. Verificare l&#39;integrità e la pervietà delle anastomosi al termine tirando un tampone di cotone prossimale a distale sopra l&#39;ileo per forzare i contenuti attraverso l&#39;anastomosi. Piccoli contenuto intestinale dovrebbero passare liberamente nel colon senza perdite anastomotica. </li><li> Sciacquare l&#39;intestino esposto con 3-4 ml di soluzione fisiologica 0,9% dalla siringa da 10 mlper lavare via feci dalla superficie delle viscere, e fornire dell&#39;intestino nella cavità peritoneale. Utilizzo di 2 ml di soluzione salina allo 0,9% sciacquare la cavità peritoneale, e poi drenare il liquido applicando una leggera pressione alla parete addominale laterale. </li><li> Chiudere l&#39;incisione con una corsa 3-0 seta sutura, e interrompere il flusso di isoflurano. Somministrare 0,1 mg / kg di oppiacei lunga durata d&#39;azione per via sottocutanea -buprenorphine- per il controllo del dolore post-operatorio. </li><li> Osservare gli animali sotto la lampada di calore fino a quando non sono mobili poi trasferirli in una gabbia continuamente riscaldato. </li></ol> 3. Cura post-operatoria e monitoraggio <ol><li> Monitorare animali in gabbia continuamente riscaldato per segni di sofferenza per il resto della giornata. Di trasferire gli animali torna alla casa di cura degli animali in una nuova gabbia sterile con accesso a dieta liquida e acqua ad lib. Gli animali possono essere inseriti in gruppi di 3-4. </li><li> Eseguire un controllo sugli animali post-operatorie la mattina seguente,garantire gli animali non appaiono in difficoltà. Alimentare solo dieta liquida. Se appaiono a disagio (ad esempio, la postura ingobbita o attività minima) somministrare un&#39;ulteriore dose di buprenorfina per via sottocutanea. Controllare gli animali ancora una volta nel pomeriggio del giorno post-operatorio 1. </li><li> La mattina del giorno post-operatorio 2 gli animali dovrebbero apparire pienamente recuperato. La prova dei consumi alimentari e stooling sono segnali positivi di ripresa. Ora, riprendere una dieta solida chow per gli animali. NOTA: Segnali di pericolo includono postura ingobbita, povero governare, e l&#39;attività minima. Se i segni di sofferenza sono importanti gli animali devono essere sacrificati. </li><li> Euthanize gli animali inducendo profonda anestesia con isoflurano 4% ad un tasso di O 2 flusso di 2 L / min fino a quando gli animali non rispondono alla pressione del piede. Eseguire dislocazione cervicale, e osservare i segni di una corretta euthanization. </li><li> Linee guida variano, in modo da fare riferimento alle raccomandazioni delle istituzioni in materia di indicazionie metodi appropriati di euthanization nei topi. </li></ol>

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	<li>Hallet, J., Zih, F. S., Lemke, M., Milot, L., Smith, A. J., Wong, C. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Neo-adjuvant+chemoradiotherapy+and+multivisceral+resection+to+optimize+R0+resection+of+locally+recurrent+adherent+colon+cancer.">Neo-adjuvant chemoradiotherapy and multivisceral resection to optimize R0 resection of locally recurrent adherent colon cancer.</a> European Journal of Surgical Oncology. 40 (6), (2014).</li><li>Rutgeerts, P., Geboes, K., Vantrappen, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Natural+history+of+recurrent+Crohn&#39;s+disease+at+the+ileocolonic+anastomosis+after+curative+surgery.">Natural history of recurrent Crohn&#39;s disease at the ileocolonic anastomosis after curative surgery.</a> Gut. 25 (6), 665-672 (1984).</li><li>Davis, D., Rivadeneira, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Complications+of+colorectal+anastomoses:+leaks,+strictures,+and+bleeding.">Complications of colorectal anastomoses: leaks, strictures, and bleeding.</a> The Surgical clinics of North America. 93 (1), 61-87 (2013).</li><li>Helmrath, M. A., VanderKolk, W. E., Can, G., Erwin, C. R., Warner, B. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intestinal+adaptation+following+massive+small+bowel+resection+in+the+mouse.">Intestinal adaptation following massive small bowel resection in the mouse.</a> Journal of the American College of Surgeons. 183 (5), 441-449 (1996).</li><li>Dekaney, C. M., Fong, J. J., Rigby, R. J., Lund, P. K., Henning, S. J., Helmrath, M. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Expansion+of+intestinal+stem+cells+associated+with+long-term+adaptation+following+ileocecal+resection+in+mice.+American+journal+of+physiology.">Expansion of intestinal stem cells associated with long-term adaptation following ileocecal resection in mice. American journal of physiology.</a> Gastrointestinal and liver physiology. 293 (5), (2007).</li><li>Speck, K. E., De Cruz, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Inflammation+enhances+resection-induced+intestinal+adaptive+growth+in+IL-10+null+mice.">Inflammation enhances resection-induced intestinal adaptive growth in IL-10 null mice.</a> The Journal of surgical research. 168 (1), 62-69 (2011).</li><li>Rigby, R. J., Hunt, M. R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+new+animal+model+of+postsurgical+bowel+inflammation+and+fibrosis:+the+effect+of+commensal+microflora.">A new animal model of postsurgical bowel inflammation and fibrosis: the effect of commensal microflora.</a> Gut. 58 (8), 1104-1112 (2009).</li><li>Kostic, A. D., Xavier, R. J., Gevers, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Microbiome+in+Inflammatory+Bowel+Disease:+Current+Status+and+the+Future+Ahead.">The Microbiome in Inflammatory Bowel Disease: Current Status and the Future Ahead.</a> Gastroenterology. , 1-11 (2014).</li><li>Gevers, D., Kugathasan, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Treatment-Naive+Microbiome+in+New-Onset+Crohn&#39;s+Disease.">The Treatment-Naive Microbiome in New-Onset Crohn&#39;s Disease.</a> Cell host &amp; microbe. 15 (3), 382-392 (2014).</li><li>Ahmed, T., Rieder, F., Fiocchi, C., Achkar, J. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pathogenesis+of+postoperative+recurrence+in+Crohn&#39;s+disease.">Pathogenesis of postoperative recurrence in Crohn&#39;s disease.</a> Gut. 60 (4), 553-562 (2011).</li><li>Borowiec, A., Sydora, B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Small+bowel+fibrosis+and+systemic+inflammatory+response+after+ileocolonic+anastomosis+in+IL-10+null+mice.">Small bowel fibrosis and systemic inflammatory response after ileocolonic anastomosis in IL-10 null mice.</a> Journal of Surgical Research. 178 (1), 147-154 (2012).</li><li>Devine, A. A., Gonzalez, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Impact of Ileocecal Resection and Concomitant Antibiotics on the Microbiome of the Murine Jejunum and Colon. 8 (8), (2013).</li><li>Bij, G. J., Oosterling, S. J., Beelen, R. H. J., Meijer, S., Coffey, J. C., van Egmond, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+perioperative+period+is+an+underutilized+window+of+therapeutic+opportunity+in+patients+with+colorectal+cancer.">The perioperative period is an underutilized window of therapeutic opportunity in patients with colorectal cancer.</a> Annals of surgery. 249 (5), (2009).</li><li>Scott, A. D., Uff, C., Phillips, R. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Suppression+of+macrophage+function+by+suture+materials+and+anastomotic+recurrence+of+Crohn&#39;s+disease.">Suppression of macrophage function by suture materials and anastomotic recurrence of Crohn&#39;s disease.</a> The British journal of surgery. 80 (3), (1993).</li><li>Kiernan, J. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intestinal+anastomosis+in+the+rat+facilitated+by+a+rapidly+digested+internal+splint+and+indigestible+but+absorbable+sutures.">Intestinal anastomosis in the rat facilitated by a rapidly digested internal splint and indigestible but absorbable sutures.</a> Journal of Surgical Research. 45, 427-431 (1988).</li><li>Andersen, T. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Action+of+matrix+metalloproteinases+at+restricted+sites+in+colon+anastomosis+repair:+an+immunohistochemical+and+biochemical+study.">Action of matrix metalloproteinases at restricted sites in colon anastomosis repair: an immunohistochemical and biochemical study.</a> Surgery. 140 (1), 72-82 (2006).</li><li>Thompson, S. K., Chang, E. Y., Jobe, B. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clinical+review:+Healing+in+gastrointestinal+anastomoses,+Part+I.">Clinical review: Healing in gastrointestinal anastomoses, Part I.</a> Microsurgery. 26 (3), 131-136 (2006).</li></ol>

The authors have nothing to disclose

Il murino ICR è un modello potente che può essere usato per studiare gli effetti della chirurgia nelle malattie intestinali. Questo articolo descrive un metodo per l&#39;esecuzione di ICR nei topi con un tasso di successo del 95% e nessun problema con difetto di crescita, come risulta da pesi stabili fino a 28 giorni dopo la procedura. Le sfide più importanti per il successo ICR includono evitare ostruzioni intestinali al anastomosi e perdite anastomotiche. Elementi tecnici per l&#39;inte...

Ileocolic resection (ICR) is a common procedure performed in both emergent and elective situations for a variety of illnesses. Crohn&#8217;s disease and colon cancers are the two most common indications for ICR. In both illnesses, recurrence in the bowel at the site of surgery represents a major clinical problem. Local recurrence rates for colon cancer remain an issue even with the most aggressive resections1. Following ICR in Crohn&#8217;s disease, the disease most frequently (in up to 80%) recurs in the neo-terminal ileum at 1 year after surgery2. Given the impact of these two illnesses and their recurrence after surgery, it is important to understand local intestinal factors after ICR, which may have intrinsic influences on the natural history of these diseases. Further, it is also important to consider anastomotic healing after ICR. In the early post-operative period, anastomotic leaks can have devastating consequences for patients resulting in repeat surgeries, stoma creations, significant morbidity, and even mortality3. Despite the importance of this topic, our current understanding of anastomotic healing remains in its infancy as a subject of research. Animal models of ICR, in particular mice, are an excellent platform for studying the intestinal and anastomotic healing following surgery.
A mouse model of ICR was initially developed by Helmrath et al. to be used as a model of short gut syndrome4. The authors experimented with various diet regiments and suture sizes to optimize animal survival following ICR. They concluded that feeding with liquid diet in the perioperative period and using 9-0 monofilament sutures resulted in an optimal post-operative survival of 88%. Since this initial publication, ICR in mice removing 50% of the small bowel has been used in several studies to explore the dynamics of massive small bowel resection and the adaptive growth response in attempt to develop new therapies for short gut syndrome5,6.
The first application of the ICR mouse model to Crohn&#8217;s disease used the IL-10-/- mouse model, which spontaneously develops colitis7. The authors found that after ICR these animals developed inflammation in the neo-terminal ileum similar to that seen in post-operative Crohn&#8217;s disease patients, and that this inflammation was dependent on the presence of bacteria7. More recently, this model was used to explore bacterial changes induced by ICR. In Crohn&#8217;s disease there is an associated dysbiosis with relative decreases in bacteria known to have anti-inflammatory properties and increases in invasive species of bacteria8,9. The association holds true in cases of post-operative recurrence10. Two studies sought to identify microbial changes resulting from ICR. The first used IL-10 null mice, and performed denaturing gel electrophoresis to compare bacterial similarity between the small bowel and colon after ICR11. This study demonstrated that bacterial populations became similar in the small intestine and colon following ICR. A subsequent study used wild type mice and 16s pyrosequencing for phylogenetic classification of bacterial species post-operatively. This study demonstrated a marked shift in bacterial species resulting from surgery alone with Clostridium species becoming dominant as well as an increase in &#978;-proteobacteria. The results also confirmed the findings of the previous study with similar populations found in the small bowel and colon after ICR12. 
ICR is a common procedure for patients with colon cancer involving the cecum and ascending colon, and it is becoming increasingly recognized that the host-response to surgery likely contributes to both local and distant tumor recurrence13. Despite this observation, models of ICR have not been utilized for the study of colorectal cancer and post-operative recurrence. Understanding both the systemic and local immunologic changes resulting from ICR will be important in investigating future therapies. Potential pathways involved in cancer recurrence post ICR include up regulation of growth factors, which may rescue cells from apoptosis and stimulate proliferation, mechanical tumor disruption with cell shedding, and loss of immune surveillance through post-operative immunosuppression13,14. 
Mouse models of ICR have the potential to be a powerful tool for the investigation of short bowel syndrome, Crohn&#8217;s disease, and colon cancer. They may also provide lessons on how to prevent early post-operative anastomotic complications by further defining the cellular and biochemical pathways involved in healing the newly constructed anastomosis. A major barrier in utilizing the murine ICR model is the technical difficulty. The intestinal anastomosis requires the use of 8-0 or 9-0 suture, an operating microscope, and training in microsurgical techniques. The goal of this article is to provide clear instructions on how to perform ICR in mice with the goal of utilizing this procedure in models of disease.

<table><tbody><tr><td>LD101 liquid rodent diet</td><td>testdiet.com</td><td></td><td></td></tr><tr><td>0.9% NaCl</td><td>Baxter</td><td>FKE1324</td><td>Injection quality saline</td></tr><tr><td>Operating Microscope</td><td>Ziess</td><td></td><td></td></tr><tr><td>Isoflurane Anesthetic Vaporizer</td><td>Harvard Apparatus</td><td>34-0483</td><td></td></tr><tr><td>Isoflurane</td><td>Abbott&amp;nbsp;</td><td>05260-05</td><td></td></tr><tr><td>Glass plate</td><td></td><td></td><td>For operating surface</td></tr><tr><td>Cotton swabs</td><td></td><td></td><td></td></tr><tr><td>Micro Castroviejo Needle holder, curved</td><td>World Precision Instruments</td><td>503377</td><td></td></tr><tr><td>Castroviejo straight scissors</td><td>World Precision Instruments</td><td>555530S</td><td></td></tr><tr><td>Dissecting Scissors</td><td>World Precision Instruments</td><td>15922</td><td></td></tr><tr><td>Dressing Forceps x 2</td><td>World Precision Instruments</td><td>500363</td><td></td></tr><tr><td>5-0 silk pre-cut sutures</td><td>Ethicon</td><td>A182H</td><td>For vessel ligation</td></tr><tr><td>8-0 Prolene on BV130-5 needle</td><td>Ethicon</td><td>8732H</td><td>For anastomosis</td></tr><tr><td>3-0 Silk on FS-2 needls</td><td>Ethicon</td><td>8665G</td><td>For abdominal wall closure</td></tr><tr><td>Petroleum Jelly</td><td>Vaseline</td><td></td><td></td></tr><tr><td>10 ml syringe</td><td>BD biosciences</td><td></td><td></td></tr><tr><td>Povidone-iodine 7.5% surgical Scrub</td><td>&lt;a href=&quot;http://betadine.com&quot;&gt;betadine.com&lt;/a&gt;</td><td></td><td></td></tr><tr><td>Heat lamps</td><td></td><td></td><td></td></tr><tr><td>buprenorphine 0.3 mg/ml</td><td>Reckitt Benckiser Healthcare Ltd.&amp;nbsp;</td><td>PL36699/0006</td><td></td></tr></tbody></table>

murine ileocolic bowel resection with primary anastomosis

Intestinal resections are frequently required for treatment of diseases involving the gastrointestinal tract, with Crohn&#8217;s disease and colon cancer being two common examples. Despite the frequency of these procedures, a significant knowledge gap remains in describing the inherent effects of intestinal resection on host physiology and disease pathophysiology. This article provides detailed instructions for an ileocolic resection with primary end-to-end anastomosis in mice, as well as essential aspects of peri-operative care to maximize post-operative success. When followed closely, this procedure yields a 95% long-term survival rate, no failure to thrive, and minimizes post-operative complications of bowel obstruction and anastomotic leak. The technical challenges of performing the procedure in mice are a barrier to its wide spread use in research. The skills described in this article can be acquired without previous surgical experience. Once mastered, the murine ileocolic resection procedure will provide a reproducible tool for studying the effects of intestinal resection in models of human disease.

I tassi di mortalità e il cambiamento di peso dopo l&#39;intervento. I tassi di mortalità seguenti ICR in 129S1 topi wild type sono in genere ~ 5%. La causa più comune della moralità è occlusione intestinale al anastomosi. Altre cause di mortalità comprendono l&#39;deiscenza anastomotica ed ernia interna per occlusione intestinale. La perdita di peso può essere visto fino a 14 giorni dopo l&#39;intervento, ma è generalmente non significativa. I topi tendono a riacquis...

Watch this Scientific Journal Video about Murine Ileocolic Bowel Resection with Primary Anastomosis at JoVE.com

Murine Ileocolic Bowel Resection with Primary Anastomosis

Ileocolic resection is commonly performed in several human diseases; however, little is known regarding the impact of intestinal resection on surgical illnesses. This article provides instruction on executing the procedure in mice with high success, providing a means to study the effects of ileocolic resection in models of disease.

Murini ileocolica resezione intestinale con anastomosi primaria

Intestinal resections are frequently required for treatment of diseases involving the gastrointestinal tract, with Crohn&#8217;s disease and colon cancer ...

murine-ileocolic-bowel-resection-with-primary-anastomosis

Universidad de Cartagena UDEC

Research

JoVE Journal

Medicine

16.3K Views.  University of Alberta. Ileocolic resection is commonly performed in several human diseases; however, little is known regarding the impact of intestinal resection on surgical illnesses. This article provides instruction on executing the procedure in mice with high success, providing a means to study the effects of ileocolic resection in models of disease.

Video: Murine Ileocolic Bowel Resection with Primary Anastomosis

Small Bowel Transplantation In Mice

Since 1990, the development of tacrolimus-based immunosuppression and improved surgical techniques, the increased array of potent immunosuppressive medications, infection prophylaxis, and suitable patient selection helped improve actuarial graft and patient survival rates for all types of intestine transplantation. Patients with irreversible intestinal failure and complications of parenteral nutrition should now be routinely considered for small intestine transplantation. However, Survival rates for small intestinal transplantation have been slow to improve compares increasingly favorably with renal, liver, heart and lung. The small bowel transplantation is still unsatisfactory compared with other organs. Further progress may depend on better understanding of immunology and physiology of the graft and can be greatly facilitated by animal models. A wider use of mouse small bowel transplantation model is needed in the study of immunology and physiology of the transplantation gut as well as efficient methods in diagnosing early rejection. However, this model is limited to use because the techniques involved is an extremely technically challenging. We have developed a modified technique. When making anastomosis of portal vein and inferior vena cava, two stay sutures are made at the proximal apex and distal apex of the recipient s inferior vena cava with the donor s portal vein. The left wall of the inferior vena cava and donor s portal vein is closed with continuing sutures in the inside of the inferior vena cava after, after one knot with the proximal apex stay suture the right wall of the inferior vena cava and the donor s portal vein are closed with continuing sutures outside the inferior vena cave with 10-0 sutures. This method is easier to perform because anastomosis is made just on the one side of the inferior vena cava and 10-0 sutures is the right size to avoid bleeding and thrombosis.  In this article, we provide details of the technique to supplement the video.

The mouse small bowel transplantation model has been recognized as an important tool to study mechanismes of immune rejection and screen new immunosuppressive drugs. However, this model is limited to use because the techniques involved is an extremely technically challenge. Now we introduce the modified technique.

Trapianto di intestino piccolo Nei topi

Since 1990, the development of tacrolimus-based immunosuppression and improved surgical techniques, the increased array of potent immunosuppressive ...

Ricerca

Biologia

Ileectomy-induced Bile Overaccumulation in Mouse Intestine

Intestinal resection is a common therapeutic approach for human diseases such as obesity, inflammatory bowel disease, Crohn's disease, and colon cancer that often results in severe short bowel syndrome-like adverse effects including bile acid diarrhea, dehydration, electrolyte disturbances, and nutrient malabsorption. Here we introduce a murine ileal resection model, termed ileectomy, to evaluate tissue communication and the maintenance of systemic homeostasis. After ileal resection, circulating blood is permanently devoid of the ileum-specific endocrine hormone fibroblast growth factor 15 (FGF15), which releases its endocrinal inhibition of bile acid synthesis in the liver. In combination with the increased production and abolished reabsorption of bile acids after removing the ileum, mice that underwent surgery suffer from bile salt overaccumulation in the intestine and associated diarrhea, morbidity, and mortality. Novel usage of the surgery model introduced in this study may provide mechanistic and functional insights into ileal control of systemic metabolic regulation in physiology and disease.

Small intestine-dependent bile acid reabsorption and feedback inhibition of hepatic bile acid synthesis is important for systemic homeostasis and health. In this study, we describe a mouse model for ileal resection to evaluate ileectomy-induced bile malabsorption, overaccumulation, and toxicity in mouse intestine.

Overaccumulation ileectomy-indotta della Bile nell'intestino del Mouse

Intestinal resection is a common therapeutic approach for human diseases such as obesity, inflammatory bowel disease, Crohn's disease, and colon cancer ...

Medicina

Murine Distal Colostomy, A Novel Model of Diversion Colitis in C57BL/6 Mice

Diversion colitis (DC) is a frequent clinical condition occurring in patients with bowel segments excluded from the fecal stream as a result of a diverting enterostomy. The etiology of this disease remains ill-defined but appears to differ from that of classical inflammatory bowel diseases such as Crohn's disease and ulcerative colitis. Research aimed to decipher the pathophysiological mechanisms leading to the development of this disease has been severely hampered by the lack of an appropriate murine model. This protocol generates a murine model of DC that facilitates the study of the immune system's role and its interaction with the microbiome in the development of DC. In this model using C57BL/6 animals, distal parts of the colon are excluded from the fecal stream by creating a distal colostomy, triggering the development of mild to moderate inflammation in the excluded bowel segments and reproducing the hallmark lesions of human DC with a moderate systemic inflammatory response. In contrast to the rat model, a large number of genetically-modified murine models on the C57BL/6 background are available. The combination of these animals with our model allows the potential roles of individual cytokines, chemokines, or receptors of bioactive molecules (e.g., interleukin (IL)-17; IL-10, chemokine CXCL13, chemokine receptors CXCR5 and CCR7, and the sphingosine-1-phosphate receptor 4) to be assessed in the pathogenesis of DC. The availability of congenic mouse strains on the C57BL/6 background largely facilitates transfer experiments to establish the roles of distinct cell types involved in the etiology of DC. Finally, the model offers the opportunity to assess the influences of local interventions (e.g., modification of the local microbiome or local anti-inflammatory therapy) on mucosal immunity in affected and non-affected bowel segments and the on systemic immune homeostasis.

Murine distal colostomy provides a murine model for human diversion colitis, a predominantly lymphocytic colitis in colon segment excluded from the fecal stream.

Murino colostomia distale, un nuovo modello di colite di diversione in topi C57BL/6

Diversion colitis (DC) is a frequent clinical condition occurring in patients with bowel segments excluded from the fecal stream as a result of a ...

Creation of Colonic Anastomosis in Mice

Intestinal anastomoses are commonly performed in both elective and emergent operations. Even so, anastomotic leaks are a highly feared complications of colonic surgeries and can occur in up to 26% of surgical anastomoses, with mortality being up to 39% for patients with such a leak. Currently, there remains a paucity of data detailing the cellular mechanisms of anastomotic healing. Devising preventative strategies and treatment modalities for anastomotic leak could be greatly potentiated by a better understanding of appropriate anastomotic healing.
A murine model is ideal as previous studies have shown that the murine anastomosis is the most clinically similar to the human case as compared with other animal models. We offer an easily reproducible murine model of colonic anastomosis in mice that will allow for further illustration of anastomotic healing.

Anastomotic leak or breakdown after surgery is a major cause of postoperative morbidity and mortality. Our surgery for creating a colonic anastomosis is a reliable and reproducible method for studying the healing mechanisms of anastomoses.

Creazione dell'anastomosi colica in topi

Intestinal anastomoses are commonly performed in both elective and emergent operations. Even so, anastomotic leaks are a highly feared complications of ...

Robotic Radical Cystectomy, Pelvic Lymph Node Dissection, and Intracorporeal Ileal Conduit Urinary Diversion

The robotic approach to radical cystectomy is compelling because of its oncologic equivalence to open radical cystectomy (ORC), its association with lower surgical blood loss, its potential association with shorter hospital stay after surgery. These factors suggest that the robotic approach to radical cystectomy may be an important component of enhanced recovery programs aimed at reducing surgical morbidity. This paper describes the importance of the cranial placement of robotic trocars, the use of Cadiere forceps for atraumatic bowel grasping, pelvic lymph node dissection (PLND), and utero-enteric anastomoses. Also discussed are steps that are critical for the successful outcome of RARC. In spite of the increased operating times and associated costs and the costs of robotic surgical platforms and equipment, adoption of the robotic technique by bladder cancer surgeons has increased. This paper describes a systematic and reproducible method that details robotic extended pelvic lymph node dissection, cystectomy/cystoprostatectomy, and intracorporeal ileal conduit urinary diversion.

This paper describes robotic radical cystectomy, pelvic lymph node dissection, and intracorporeal ileal conduit urinary diversion.

The robotic approach to radical cystectomy is compelling because of its oncologic equivalence to open radical cystectomy (ORC), its association with lower ...

<meta charset="utf8"></head><body>Modello murino per lo studio dell'ileo postoperatorio attraverso la manipolazione intestinale

Postoperative Ileus Murine Model

Most patients experience postoperative ileus (POI) after surgery, which is associated with increased morbidity, mortality, and hospitalization time. POI is a consequence of mechanical damage during surgery, resulting in disruption of motility in the gastrointestinal tract. The mechanisms of POI are related to aberrant neuronal sensitivity, impaired epithelial barrier function, and increased local inflammation. However, the details remain enigmatic. Therefore, experimental murine models are crucial for elucidating the pathophysiology and mechanism of POI injury and for the development of novel therapies.
Here, we introduce a murine model of POI generated via intestinal manipulation (IM) that is similar to clinical surgery; this is achieved by mechanical damage to the small intestine by massaging the abdomen 1-3 times with a cotton swab. IM delayed gastrointestinal transit 24 h after surgery, as assessed by FITC-dextran gavage and fluorescence detection of the segmental digestive tract. Moreover, tissue swelling of the submucosa and immune cell infiltration were investigated by hematoxylin and eosin staining and flow cytometry. Proper pressure of the IM and a hyperemic effect on the intestine are critical for the procedure. This murine model of POI can be utilized to study the mechanisms of intestinal damage and recovery after abdominal surgery.

<meta charset="utf8"></head><body>Modello murino di ileo postoperatorio

We describe a murine model of postoperative ileus generated via intestinal manipulation. Gastrointestinal transit function, pathologic changes, and immune cell activation were assessed 24 h after surgery.

Modello murino di ileo postoperatorio

Most patients experience postoperative ileus (POI) after surgery, which is associated with increased morbidity, mortality, and hospitalization time. POI ...

Immunologia e infezioni

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer

Since their approval for clinical use, da Vinci surgical robots have shown great advantages in gastrointestinal surgical operations, especially in complex procedures. The high-quality 3-D visual, multijoint arm and natural tremor filtration allow the surgeon to expose and dissect more accurately with minimal invasion. Total mesorectal excision is the standard surgical technique for the treatment of resectable rectal cancer. To reduce the lateral recurrence rate, lateral pelvic lymph node dissection can be performed, as it is a safe and feasible procedure for locally advanced middle-low rectal cancer with a high possibility of metastasis to the lateral lymph nodes. However, the complexity of the anatomic structures and the high postoperative complication rate limit its application. Recently, several surgeons have increasingly used robotic techniques for total mesorectal excision and lateral pelvic lymph node dissection. Compared with open and laparoscopic surgery, the robotic technique has several advantages, such as less blood loss, fewer blood transfusions, minimal trauma, shorter postoperative hospitalization, and quicker recovery. A robotic approach is generally regarded as a reasonable alternative for complicated procedures such as lateral pelvic lymph node dissection, although there are a limited number of high-quality prospective randomized controlled studies reporting direct evidence. Here, we provide the detailed steps of robot-assisted total mesorectal excision and lateral pelvic lymph node dissection performed at the First Affiliated Hospital of Xi&#39;an Jiaotong University.

The robotic technique described herein aims to detail a stepwise approach to robot-assisted total mesorectal excision and lateral pelvic lymph node dissection for locally advanced (T3/T4) rectal cancer located below the peritoneal reflection.

Escissione mesorettale totale assistita da robot e dissezione del linfonodo pelvico laterale per il cancro del retto medio-basso localmente avanzato

Since their approval for clinical use, da Vinci surgical robots have shown great advantages in gastrointestinal surgical operations, especially in complex ...

Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy Model in Mice

Obesity is a major health issue worldwide. As a response, bariatric surgeries have emerged to treat obesity and its related comorbidities (e.g., diabetes mellitus, dyslipidemia, non-alcoholic steatohepatitis, cardiovascular events, and cancers) through restrictive and malabsorptive mechanisms. Understanding the mechanisms by which these procedures allow such improvements often require their transposition into animals, especially in mice, because of the ease of generating genetically modified animals. Recently, the single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) has emerged as a procedure that uses both restrictive and malabsorptive effects, which is being used as an alternative to gastric bypass in case of major obesity. Thus far, this procedure has been associated with strong metabolic improvements, which has led to a marked increase in its use in daily clinical practice. However, the mechanisms underlying these metabolic effects have been poorly studied as a result of a lack of animal models. In this article, we present a reliable and reproducible model of SADI-S in mice, with a special focus on perioperative management. The description and use of this new rodent model will be helpful for the scientific community to better understand the molecular, metabolic, and structural changes induced by the SADI-S and to better define the surgical indications for clinical practice.

Single-anastomosis duodeno-ileal bypass (SADI-S) is an emerging bariatric procedure with important metabolic effects. In this article, we present a reliable and reproducible model of SADI-S in mice.

Bypass duodeno-ileale a singola anastomosi con modello di gastrectomia a manica nei topi

Obesity is a major health issue worldwide. As a response, bariatric surgeries have emerged to treat obesity and its related comorbidities (e.g., diabetes ...

Murini ileocolica resezione intestinale con anastomosi primaria

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Trapianto di intestino piccolo Nei topi

Overaccumulation ileectomy-indotta della Bile nell'intestino del Mouse

Murino colostomia distale, un nuovo modello di colite di diversione in topi C57BL/6

Creazione dell'anastomosi colica in topi

Robotic Radical Cystectomy, Pelvic Lymph Node Dissection, and Intracorporeal Ileal Conduit Urinary Diversion

Modello murino di ileo postoperatorio

Modello murino di ileo postoperatorio

Modello murino di ileo postoperatorio

Escissione mesorettale totale assistita da robot e dissezione del linfonodo pelvico laterale per il cancro del retto medio-basso localmente avanzato

Bypass duodeno-ileale a singola anastomosi con modello di gastrectomia a manica nei topi