Artikel
Modified Spiral Intestinal Lengthening for Short Bowel Syndrome
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Veröffentlicht: | 21. April 2016 |
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Gliederung
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Background: The Spiral Intestinal Lengthening and Tailoring (SILT) procedure is a new surgical tecnique 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 two pigs to determine the technical feasibility. Thereafter, the short-term clinical feasibility was monitored clinically in two dogs by gastrointestinal X-ray series at postoperative day 4 and by relaparatomy 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.
Conclusion: 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.