Submucosal endoscopic myotomies for esophageal lengthening: a novel minimally invasive technique with feasibility study.
Fiche publication
Date publication
juin 2012
Auteurs
Membres identifiés du Cancéropôle Est :
Pr MARESCAUX Jacques
Tous les auteurs :
Wall J, Perretta S, Diana M, Dhumane P, Haro JI, Dallemagne B, Becmeur F, Krummel T, Marescaux J
Lien Pubmed
Résumé
BACKGROUND: Replacement conduits carry significant morbidity in long gap esophageal atresia. Surgical myotomies can lengthen the esophagus, but have not gained widespread adoption due to long-term dilatation. The aim of this study is to assess the feasibility of an emerging minimally invasive technique of submucosal endoscopic myotomy for esophageal lengthening. METHODS: Bilateral submucosal lengthening endoscopic myotomies (BSLEM) were performed in three swine. Circular esophageal muscle fibers were selectively divided in a bilateral 3 cm longitudinal pattern. Ex-vivo tensile testing was performed on the BSLEM and compared with three circular myotomies, three spiral myotomies, and three controls. RESULTS: BSLEM was completed in all cases with one esophageal microperforation. The mean operating time was 38 minutes. Over physiologic force ranges of 0 to 100 g, the percentage esophageal elongation was significantly different among the four groups (p
Référence
Eur J Pediatr Surg. 2012 Jun;22(3):217-21