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Asociación Mexicana de Gastroenterología

2005, Number 3

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Rev Gastroenterol Mex 2005; 70 (3)

Intestinal lengthening techniques: An experimental model in dogs

Garibay GF, Díaz MDA, Valencia FA, González HMA

Language: Spanish
References: 26
Page: 269-275
PDF size: 56.19 Kb.


ABSTRACT

Objective: To compare two intestinal lengthening procedures in an experimental dog model. Background: Intestinal lengthening is one of the methods for gastrointestinal reconstruction used for treatment of short bowel syndrome. The modification to the Bianchi’s technique is an alternative. The modified technique decreases the number of anastomoses to a single one, thus reducing the risk of leaks and strictures. To our knowledge there is not any clinical or experimental report that studied both techniques, so we realized the present report. Methods: Twelve creole dogs were operated with the Bianchi technique for intestinal lengthening (group A) and other 12 creole dogs from the same race and weight were operated by the modified technique (Group B). Both groups were compared in relation to operating time, difficulties in technique, cost, intestinal lengthening and anastomoses diameter. Results: There were no statistical difference in the anastomoses diameter (A = 9.0 mm vs. B = 8.5 mm, p = 0.3846). Operating time (142 min vs. 63 min) cost and technique difficulties were lower in group B (p ‹ 0.0001). Intestinal lengthening was greater in group B (p = 0.0006). At the end of surgery as well as four hours later, all except one of the anastomoses (of Group B) and intestinal segments had good blood supply and were patent along their full length. Conclusion: Bianchi technique and the modified technique offer two good reliable alternatives for the treatment of short bowel syndrome. The modified technique improved operating time, cost and technical issues.


REFERENCES

  1. Short bowel syndrome. National Library of Medicine - Medical Subject Headings. Mesh 2005. http://www.nlm.nih.gov/mesh/MBrowser.html

  2. Carlson GL. Surgical management of intestinal failure. Proc Nutr Soc 2003; 62: 711-8.

  3. Thompson JS, Langnas AN, Pinch LW. Surgical approach to short-bowel syndrome. Experience in a population of 160 patients. Ann Surg 1995; 222: 600-5.

  4. O’Neill JA. Short-Bowel Syndrome. In: O’Neill JA, Grosfeld JL, et al. (eds.). Principles of pediatric surgery. 2a. Ed. St Louis, Missouri: Mosby; 2003, p. 519-25.

  5. Schalamon J, Mayr JM, Hollwarth ME. Mortality and economics in short bowel syndrome. Best Pract Res Clin Gastroenterol 2003; 17: 931-42.

  6. Kim HB, Lee PW, Garza J et al. Serial transverse enteroplasty for short bowel syndrome: a case report. J Pediatr Surg 2003; 38: 881-5.

  7. Javid PJ, Kim HB, Duggan CP, Jaksic T. Serial transverse enteroplasty is associated with successful short-term outcomes in infants with short bowel syndrome. J Pediatr Surg 2005; 40: 1019-23.

  8. Kato T, Mittal N, Nishida S, et al. The role of intestinal transplantation in the management of babies with extensive gut resections. J Pediatr Surg 2003; 38: 145-9.

  9. Falcone RA, Warner BW. Short-bowel syndrome. In: Ziegler MM, Azizkhan RG, Weber TR (eds.). Operative pediatric surgery. New York, NY: McGraw-Hill; 2003: 699-712.

  10. Millar JW, Rode H y Cywes S. Intestinal atresia and stenosis. In: Ashcraft KW, Holcomb GW, Murphy JP (ed.). Pediatric surgery. 4th. Philadelphia, Pennsylvania: Ed. Saunders; 2005, 416-34.

  11. Dias AI, Martins JL, Moriya EM, Seda NJ. Helicoidal enteromyotomy in rats: an experimental model of intestinal lengthening. Transplant Proc 2004; 36: 1012-4.

  12. Collins JB, Georgeson KE. Short bowel syndrome. Sem Pediatr Surg 1995; 4: 60-9.

  13. Bianchi A. Intestinal loop lengthening- a technique for increasing small intestinal length. J Pediatr Surg 1980; 15: 145-50.

  14. Bianchi A. Intestinal lengthening: an experimental an clinical review. J R Soc Med 1984; 77: 35-41.

  15. Bianchi A. Autologous gastrointestinal reconstruction. Semin Pediatr Surg 1995; 4: 54-9.

  16. Bianchi A. Experience with longitudinal intestinal lengthening and tailoring. Eur J Pediatr Surg 1999; 9: 256-9.

  17. Chahine A y Ricketts R. A modification of the Bianchi intestinal lengthening procedure with a single anastomosis. J Pediatr Surg 1998; 33: 1292-3.

  18. GraphPad Software Inc. 1995-2005, San Diego, Cal http://www.graphpad.com

  19. Wales PW, de Silva N, Kim J, Lecce L, To T, Moore A. Neonatal short bowel syndrome: population-based estimates of incidence and mortality rates. J Pediatr Surg 2004; 39: 690-5.

  20. Bakonyi NA, Takegawa B, Ortolan E, et al. Demographic of short gut syndrome: increasing demand is not followed by referral of potential candidates for small bowel transplantation. Transplant Proc 2004; 36: 259-60.

  21. Park J, Puapong DP, Wu BM. Enterogenesis by mechanical lengthening: morphology and function of the lengthened small intestine. J Pediatr Surg 2004; 39: 1823-7.

  22. Tannuri U. Serial transverse enteroplasty (STEP): a novel bowel lengthening procedure, and serial transverse enteroplasty for short bowel syndrome. J Pediatr Surg 2003; 38: 1845.

  23. Kimura K, Soper RT. A new bowel elongation technique for the short bowel syndrome using the isolated bowel segment Iowa models. J Pediatr Surg 1993; 28: 792-4.

  24. Kimura K, Soper RT. Isolated bowel segment (model 1) creation by myoenteropexy. J Pediatr Surg 1990; 25: 512-3.

  25. Pokorny WJ, Fowler CI. Isoperistaltic intestinal lengthening for short bowel syndrome. Surg Gynecol Obstet 1991; 172: 39-43.

  26. Kim HB, Fauza D, Garza J, et al. Serial transverse enteroplasty (STEP): a novel bowel lengthening procedure. J Pediatr Surg 2003; 38: 425-9.




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