An assessment of the risk of neoplasia in long-term ileal reservoirs using the DMH rodent model

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Abstract
Ectal anastomosis (n=20), 3) total colectomy with an ileal reservoir made of terminal ileum sutured to the rectum (n=20). An adaptation period of 12 weeks was allowed to promote fecal stasis and the histologic changes before exposure to weekly subcutaneous injections of DMH (25 mg/kg) for 16 weeks. Sodium butyrate was added to the diet as a tumor promotor. All animals were sacrificed one month later. Fecal stasis, along with enlargement, occurred in all the reservoirs (mean dimensions, 74×58×43 mm). Their mean volume was 88±14 ml. The histologic changes in the ileal reservoirs were: chronic inflammation (14/20), villous atrophy (14/20), and atrophy of the glands (8/20). In group 3, five carcinomas were seen. There were three in the duodenum and two in the reservoirs. In contrast, 21 carcinomas were detected in the control groups. There were 17 in the colon, 3 in the jejunum, and 1 in the ileum. No significant difference in the number of carcinomas was seen in the ileum with and without reservoir. Although it is possible to induce carcinomas in ileal reservoirs, the incidence remained significantly less than in the colon. In conclusion, the histologic changes induced by the construction of an ileal reservoir do not increase the risk of malignant transformation in the DMH model for intestinal carcinogenesis. Preliminary report presented at the meeting of the American Society of Colon and Rectal Surgeons, Washington, D.C., April 5 to 10, 1987. Winner of the New Jersey Society of Colon and Rectal Surgeons award for the best poster presentation. Supported in part by the Canadian Foundation for Ileitis and Colitis and the National Cancer Institute of Canada for the preliminary studies. © The ASCRS 1990...