BACKGROUND: Serial transverse enteroplasty (STEP) lengthens and tapers dilated bowel. Redilation of the STEP segment occurs in some patients with intestinal failure. The feasibility of a repeat STEP procedure in a pig model is evaluated. METHODS: Six pigs underwent reversal of an intestinal segment distal to the ligament of Treitz. At 6-week intervals after reversal, each animal had 2 STEP procedures on the bowel proximal to the reversed segment. Necropsy was performed up to 6 weeks after repeat STEP. RESULTS: Bowel length increased by 11.3 +/- 3.9 cm and bowel diameter decreased from a mean of 5.3 +/- 0.8 to 1.8 +/- 0.4 cm (P < .0001) after the first STEP. After repeat STEP, bowel length increased by 16.7 +/- 13.3 cm (P < .01), and the bowel was tapered from a mean of 5.4 +/- 0.9 to 2.2 +/- 0.4 cm (P < .01). Five pigs did well after repeat STEP, and 1 pig had early necropsy for bowel obstruction. None had histologic evidence of bowel ischemia in the repeat STEP segment. CONCLUSIONS: A second STEP operation is feasible in a pig model and may be considered to optimize bowel length and function in select patients with intestinal failure.
BACKGROUND: Serial transverse enteroplasty (STEP) lengthens and tapers dilated bowel. Redilation of the STEP segment occurs in some patients with intestinal failure. The feasibility of a repeat STEP procedure in a pig model is evaluated. METHODS: Six pigs underwent reversal of an intestinal segment distal to the ligament of Treitz. At 6-week intervals after reversal, each animal had 2 STEP procedures on the bowel proximal to the reversed segment. Necropsy was performed up to 6 weeks after repeat STEP. RESULTS: Bowel length increased by 11.3 +/- 3.9 cm and bowel diameter decreased from a mean of 5.3 +/- 0.8 to 1.8 +/- 0.4 cm (P < .0001) after the first STEP. After repeat STEP, bowel length increased by 16.7 +/- 13.3 cm (P < .01), and the bowel was tapered from a mean of 5.4 +/- 0.9 to 2.2 +/- 0.4 cm (P < .01). Five pigs did well after repeat STEP, and 1 pig had early necropsy for bowel obstruction. None had histologic evidence of bowel ischemia in the repeat STEP segment. CONCLUSIONS: A second STEP operation is feasible in a pig model and may be considered to optimize bowel length and function in select patients with intestinal failure.
Authors: Per T Sangild; Denise M Ney; David L Sigalet; Andreas Vegge; Douglas Burrin Journal: Am J Physiol Gastrointest Liver Physiol Date: 2014-10-23 Impact factor: 4.052
Authors: Brian A Jones; Melissa A Hull; Kristina M Potanos; David Zurakowski; Shimae C Fitzgibbons; Y Avery Ching; Christopher Duggan; Tom Jaksic; Heung Bae Kim Journal: J Am Coll Surg Date: 2013-01-26 Impact factor: 6.113