Modified Spiral Intestinal Lengthening and Tailoring for Short Bowel Syndrome.

Autor:	Mehrabi V; University of Medical Science, Tehran, Iran., Mehrabi A; Heidelberg University, Heidelberg, Germany arianeb.mehrabi@med.uni-heidelberg.de., Jamshidi SH; University of Medical Science, Tehran, Iran., Pedram MS; University of Medical Science, Tehran, Iran., Sabagh MS; Tehran University of Medical Science, Shariati, Iran., Jaberansari N; Tehran University of Medical Science, Shariati, Iran., Fonouni HR; Heidelberg University, Heidelberg, Germany., Sharifi AH; Tehran University of Medical Science, Shariati, Iran., Malekzadeh R; Tehran University of Medical Science, Shariati, Iran., Frongia G; Heidelberg University, Heidelberg, Germany.
Jazyk:	angličtina
Zdroj:	Surgical innovation [Surg Innov] 2016 Feb; Vol. 23 (1), pp. 30-5. Date of Electronic Publication: 2015 Jul 27.
DOI:	10.1177/1553350615596639
Abstrakt:	Background: The spiral intestinal lengthening and tailoring (SILT) procedure is a new surgical technique for autologous intestinal reconstruction in patients with short bowel syndrome. The aim of this work is to present a first description of a modified SILT technique by which the mucosal layer is left intact to possibly reduce the severe postoperative complications of intestinal leakage and abdominal abscess formation. Materials and Methods: The modified SILT technique was performed on a 10-cm-long intestinal segment in 2 pigs to determine the technical feasibility. Thereafter, the short-term clinical feasibility was monitored clinically in 2 dogs by gastrointestinal X-ray series at postoperative day 4 and by relaparotomy postoperative day 10. Results: It was technically feasible to lengthen the intestinal segment from 10 cm to 20 cm and tailoring it from 3 cm to 1.7 cm in diameter, while leaving the intestinal mucosal layer intact. The postoperative course was uneventful for both dogs. The gastrointestinal X-ray series showed an inconspicuous intestinal transit time without any signs of stricture, perforation, or leakage. In the relaparotomy, the initially achieved lengthening and tailoring extents were preserved and the operated intestinal segment was well perfused with no early signs of necrosis, stenosis, or leakage. Conclusions: Leaving the mucosal layer intact during SILT is technically and clinically feasible in the short term in a large animal model. Further studies are needed to fully assess the impact of this technical modification on the long-term outcome of larger series. (© The Author(s) 2015.)
Databáze:	MEDLINE
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