Subscribe to RSS
DOI: 10.1055/s-0036-1593386
The Effect of Intramural Botulinum Toxin Injections on the Elongation of the Piglet Oesophagus Is Time Dependent
Publication History
07 April 2016
15 August 2016
Publication Date:
03 October 2016 (online)
![](https://www.thieme-connect.de/media/ejps/201701/lookinside/thumbnails/10-1055-s-0036-1593386_163712oa-1.jpg)
Abstract
Introduction One in 4,000 infants is born with oesophageal atresia. Approximately 15% of these have a long gap oesophageal atresia, where primary anastomosis is difficult or impossible. Previous studies have shown an effect of intramural botulinum toxin type A (BTX-A) injections on the elongation and max load of the esophagus 1 hour after injection. We hypothesized that a longer waiting period of 2 hours could increase this effect.
Methods Forty-five piglets were randomized into three groups. Two treatment groups received 2 units/kg of BTX-A and one group received saline. After 1 or 2 hours, a segment of the esophagus was harvested and put in a stretch-tension device to assess elongation and max load.
Results Elongation from preload to max load and percentage elongation in the BTX-A 2h group (17.09 mm, 46.46%) was significantly higher compared with the BTX-A 1h group (13.59 mm, 40.16%) and the placebo group (13.77 mm, 39.92%).
Conclusion Elongation of the piglet esophagus was significantly improved with a 2-hour waiting period after BTX-A injection. Injections with BTX-A could be useful in oesophageal atresia, where primary anastomosis is not possible.
* The authors Christian Bakholdt Dibbern and Morten Rose have contributed equally to the article.
-
References
- 1 Pedersen RN, Calzolari E, Husby S, Garne E ; EUROCAT Working Group. Oesophageal atresia: prevalence, prenatal diagnosis and associated anomalies in 23 European regions. Arch Dis Child 2012; 97 (3) 227-232
- 2 Nassar N, Leoncini E, Amar E , et al. Prevalence of esophageal atresia among 18 international birth defects surveillance programs. Birth Defects Res A Clin Mol Teratol 2012; 94 (11) 893-899
- 3 von Allmen D, Wijnen RM. Bridging the gap in the repair of long-gap esophageal atresia: still questions on diagnostics and treatment. Eur J Pediatr Surg 2015; 25 (4) 312-317
- 4 Gallo G, Zwaveling S, Groen H, Van der Zee D, Hulscher J. Long-gap esophageal atresia: a meta-analysis of jejunal interposition, colon interposition, and gastric pull-up. Eur J Pediatr Surg 2012; 22 (6) 420-425
- 5 Pinheiro PF, Simões e Silva AC, Pereira RM. Current knowledge on esophageal atresia. World J Gastroenterol 2012; 18 (28) 3662-3672
- 6 Sroka M, Wachowiak R, Losin M , et al. The Foker technique (FT) and Kimura advancement (KA) for the treatment of children with long-gap esophageal atresia (LGEA): lessons learned at two European centers. Eur J Pediatr Surg 2013; 23 (1) 3-7
- 7 Lacy BE, Weiser K, Kennedy A. Botulinum toxin and gastrointestinal tract disorders: panacea, placebo, or pathway to the future?. Gastroenterol Hepatol (N Y) 2008; 4 (4) 283-295
- 8 Ellebæk M, Qvist N, Rasmussen L. Secondary anastomosis after preoperative botulinum type A toxin injection in a case with long gap oesophageal atresia. Eur J Pediatr Surg 2013; 23 (4) 325-326
- 9 Mach-Detiefsen B. P-56 Botox injection for primary oesophageal anastomosis in two preterms with oesophageal atresia type IIIA and type II. 12th European Congress of Pediatric Surgery; June 15–18, 2011; Barcelona
- 10 Larsen HF, Jensen TS, Rasmussen L, Ellebæk M, Qvist N. Intramural injection with botulinum toxin significantly elongates the pig esophagus. J Pediatr Surg 2013; 48 (10) 2032-2035
- 11 Ellebæk MB, Qvist N, Schrøder HD, Rasmussen L. Intramural injection with botulinum toxin type A in piglet esophagus. The influencer on maximum load and elongation: a dose response study. Eur J Pediatr Surg 2016; 26 (3) 282-286
- 12 Weiss M, Hansen TG, Engelhardt T. Ensuring safe anaesthesia for neonates, infants and young children: what really matters. Arch Dis Child 2016; 101 (7) 650-652
- 13 Frevert J. Xeomin: an innovative new botulinum toxin type A. Eur J Neurol 2009; 16 (Suppl. 02) 11-13