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Serial transverse enteroplasty (STEP): a novel bowel lengthening procedure.
J Pediatr Surg. 2003 Mar; 38(3):425-9.JP

Abstract

BACKGROUND/PURPOSE

Bowel lengthening may be beneficial for children with short bowel syndrome. However, current techniques require at least one intestinal anastomosis and place the mesenteric blood supply at risk. This study seeks to establish the technical principles of a new, simple, and potentially safer bowel lengthening procedure.

METHODS

Young pigs (n = 6) underwent interposition of a reversed intestinal segment to produce proximal small bowel dilation. Five weeks later the reversed segment was resected. Lengthening of the dilated bowel then was performed by serial transverse applications of a GIA stapler, from opposite directions, to create a zig zag channel. A distal segment of equal length served as an in situ morphometric control. Contrast radiologic studies were performed 6 weeks later, and the animals were killed. Statistical comparisons were made by paired t test with P less than.05 considered significant.

RESULTS

After bowel lengthening, all animals gained weight (66.7 +/- 3.0 [SD] kg v 42.5 +/- 3.5 kg; P <.001) and showed no clinical or radiologic evidence of intestinal obstruction. Intraoperatively, immediately after serial transverse enteroplasty, the intestine was substantially elongated (82.8 +/- 6.7 cm v 49.2 +/- 2 cm; P <.01). Six weeks after surgery, the lengthened intestinal segment became practically straight and, compared with the in situ control, remained significantly longer (80.7 +/- 13.1 cm v 57.2 +/- 10.4 cm; P <.01). There was no difference in diameter between these segments (4.3 +/- 0.7 cm v 3.8 +/- 0.4 cm; P value, not significant).

CONCLUSIONS

Serial transverse enteroplasty (STEP) significantly increases intestinal length without any evidence of obstruction. This procedure may be a safe and facile alternative for intestinal lengthening in children with short bowel syndrome.

Authors+Show Affiliations

Department of Surgery, Children's Hospital and Harvard Medical School, and Harvard Center for Minimally Invasive Surgery, Boston, Massachusetts 02115, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12632361

Citation

Kim, Heung Bae, et al. "Serial Transverse Enteroplasty (STEP): a Novel Bowel Lengthening Procedure." Journal of Pediatric Surgery, vol. 38, no. 3, 2003, pp. 425-9.
Kim HB, Fauza D, Garza J, et al. Serial transverse enteroplasty (STEP): a novel bowel lengthening procedure. J Pediatr Surg. 2003;38(3):425-9.
Kim, H. B., Fauza, D., Garza, J., Oh, J. T., Nurko, S., & Jaksic, T. (2003). Serial transverse enteroplasty (STEP): a novel bowel lengthening procedure. Journal of Pediatric Surgery, 38(3), 425-9.
Kim HB, et al. Serial Transverse Enteroplasty (STEP): a Novel Bowel Lengthening Procedure. J Pediatr Surg. 2003;38(3):425-9. PubMed PMID: 12632361.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serial transverse enteroplasty (STEP): a novel bowel lengthening procedure. AU - Kim,Heung Bae, AU - Fauza,Dario, AU - Garza,Jennifer, AU - Oh,Jung-Tak, AU - Nurko,Samuel, AU - Jaksic,Tom, PY - 2003/3/13/pubmed PY - 2003/11/6/medline PY - 2003/3/13/entrez SP - 425 EP - 9 JF - Journal of pediatric surgery JO - J Pediatr Surg VL - 38 IS - 3 N2 - BACKGROUND/PURPOSE: Bowel lengthening may be beneficial for children with short bowel syndrome. However, current techniques require at least one intestinal anastomosis and place the mesenteric blood supply at risk. This study seeks to establish the technical principles of a new, simple, and potentially safer bowel lengthening procedure. METHODS: Young pigs (n = 6) underwent interposition of a reversed intestinal segment to produce proximal small bowel dilation. Five weeks later the reversed segment was resected. Lengthening of the dilated bowel then was performed by serial transverse applications of a GIA stapler, from opposite directions, to create a zig zag channel. A distal segment of equal length served as an in situ morphometric control. Contrast radiologic studies were performed 6 weeks later, and the animals were killed. Statistical comparisons were made by paired t test with P less than.05 considered significant. RESULTS: After bowel lengthening, all animals gained weight (66.7 +/- 3.0 [SD] kg v 42.5 +/- 3.5 kg; P <.001) and showed no clinical or radiologic evidence of intestinal obstruction. Intraoperatively, immediately after serial transverse enteroplasty, the intestine was substantially elongated (82.8 +/- 6.7 cm v 49.2 +/- 2 cm; P <.01). Six weeks after surgery, the lengthened intestinal segment became practically straight and, compared with the in situ control, remained significantly longer (80.7 +/- 13.1 cm v 57.2 +/- 10.4 cm; P <.01). There was no difference in diameter between these segments (4.3 +/- 0.7 cm v 3.8 +/- 0.4 cm; P value, not significant). CONCLUSIONS: Serial transverse enteroplasty (STEP) significantly increases intestinal length without any evidence of obstruction. This procedure may be a safe and facile alternative for intestinal lengthening in children with short bowel syndrome. SN - 1531-5037 UR - https://www.unboundmedicine.com/medline/citation/12632361/Serial_transverse_enteroplasty__STEP_:_a_novel_bowel_lengthening_procedure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022346802630817 DB - PRIME DP - Unbound Medicine ER -