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Esophagus

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A new esophageal elongation technique for long-gap esophageal atresia: in vitro comparison of myotomy techniques

  • Burhan Beger
  • Orhan Beger
Original Article
  • 19 Downloads

Abstract

Background

Complications such as stricture, leakage, recurrent tracheoesophageal fistula and mucosal pouch are commonly seen in myotomy techniques used for long-gap esophageal atresia (LGEA) treatments. Therefore, we think that there is a clear need for other techniques which would enable us to create more robust and longer esophagus in such cases. In this study, we reviewed multiple V-myotomy (VM) technique and the differences of the said technique with Livaditis circular myotomy (LM) and Kimura spiral myotomy (KM) techniques using literature as an aid.

Methods

21 esophagus samples from 21 male lambs aged 12 months were used in vitro for the study. All esophageal samples were matched to have a length of 120 mm. Samples were divided into 3 groups of 7 and VM, LM and KM techniques were used in each group, respectively. Post-op esophagus lengths, elongation amount with each incision and perforation pressures were measured.

Results

Post-op esophageal lengths were measured as 227, 210 and 200 mm for VM, LM and KM, respectively. Elongation amount per incision was measured as 5.1, 4 and 3.34 mm, again in previous order of VM, LM, and KM. Finally, perforation pressure following VM, LM, and KM was measured as 460, 400, and 410 mmHg.

Conclusion

VM was found to significantly increase total esophagus length and elongation per incision over LM and KM. In addition, VM was also shown to have a higher perforation pressure. Although in vivo live animal studies are required, we can say that VM can be used to create longer and robust esophagus.

Keywords

Esophagus atresia Kimura technique Livaditis technique Long-gap esophagus atresia Newborn 

Notes

Acknowledgements

We thank Atilla Bayram for the illustration.

Author contributions

BB project development, data collection, data analysis, manuscript writing, and manuscript editing. OB data collection, data analysis, and manuscript writing.

Funding

None.

Compliance with ethical standards

Ethical Statement

As esophagus samples were collected from a slaughterhouse, no ethics committee approval was required due to legal procedures in our country.

Conflict of interest

B.B and O.B have no conflict of interest or financial ties to disclose.

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Copyright information

© The Japan Esophageal Society and Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Pediatric SurgeryVan Yüzüncü Yıl University Faculty of MedicineVanTurkey
  2. 2.Department of AnatomyMersin University Faculty of MedicineMersinTurkey

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