EARLIER diagnosis and better surgical management of mesenteric infarction has increased the number of patients arriving at a stage of chronic malabsorption consequent to massive intestinal resection.
Prominent among efforts to minimize nutritional deficiency after massive bowel resection has been surgical alteration of bowel continuity and of normal peristaltic dynamics (Table 1). Investigation in this direction has usually been carried out in dogs. Segments of small bowel have been reversed so that antiperistalsis would retard passage of intestinal contents and would thus allow greater time for absorption of nutrients.1,2 Construction of loops of residual small intestine to allow recirculation of food through the same segment several times before its passage to the large intestine has been tried.3 The combination of a reversed intestinal segment distal to a recirculating loop has also been studied.4,5 Pyloroplasty and vagotomy was found to improve bowel function and absorption after massive intestinal
MAY AG, PHILLIPS CE, SHERMAN CD. Massive Intestinal Resection: Are Adjunctive Surgical Procedures Necessary? Arch Surg. 1966;92(3):344–348. doi:10.1001/archsurg.1966.01320210024004
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