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The second STEP: the feasibility of repeat serial transverse enteroplasty.
J Pediatr Surg. 2006 Dec; 41(12):1951-6.JP

Abstract

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+Show Affiliations

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

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17161180

Citation

Piper, Hannah, et al. "The Second STEP: the Feasibility of Repeat Serial Transverse Enteroplasty." Journal of Pediatric Surgery, vol. 41, no. 12, 2006, pp. 1951-6.
Piper H, Modi BP, Kim HB, et al. The second STEP: the feasibility of repeat serial transverse enteroplasty. J Pediatr Surg. 2006;41(12):1951-6.
Piper, H., Modi, B. P., Kim, H. B., Fauza, D., Glickman, J., & Jaksic, T. (2006). The second STEP: the feasibility of repeat serial transverse enteroplasty. Journal of Pediatric Surgery, 41(12), 1951-6.
Piper H, et al. The Second STEP: the Feasibility of Repeat Serial Transverse Enteroplasty. J Pediatr Surg. 2006;41(12):1951-6. PubMed PMID: 17161180.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The second STEP: the feasibility of repeat serial transverse enteroplasty. AU - Piper,Hannah, AU - Modi,Biren P, AU - Kim,Heung Bae, AU - Fauza,Dario, AU - Glickman,John, AU - Jaksic,Tom, PY - 2006/12/13/pubmed PY - 2007/1/4/medline PY - 2006/12/13/entrez SP - 1951 EP - 6 JF - Journal of pediatric surgery JO - J Pediatr Surg VL - 41 IS - 12 N2 - 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. SN - 1531-5037 UR - https://www.unboundmedicine.com/medline/citation/17161180/The_second_STEP:_the_feasibility_of_repeat_serial_transverse_enteroplasty_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3468(06)00579-3 DB - PRIME DP - Unbound Medicine ER -