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Eur J Pediatr Surg 2022; 32(05): 460-464
DOI: 10.1055/s-0042-1745783
Original Article

Endoscopic Injections of Botulinum Toxin Type A in the Piglet Esophagus Is Safe and Feasible but Did Not Result in any Significant Structural Changes 3 Days after Injection

Morten Rose
1   Department of Surgery, Odense University Hospital, Odense, Syddanmark, Denmark
,
Patrick Clarke
2   Department of Surgery, University of Vermont Larner College of Medicine, Burlington, Vermont, United States
,
Ashton H. Pike
2   Department of Surgery, University of Vermont Larner College of Medicine, Burlington, Vermont, United States
,
Peter Zvara
3   Department of Clinical Research, University of Southern Denmark, Odense, Syddanmark, Denmark
,
Henrik D. Schrøder
4   Department of Clinical Pathology, Odense University Hospital, Odense, Syddanmark, Denmark
,
Eva K. Hejboel
4   Department of Clinical Pathology, Odense University Hospital, Odense, Syddanmark, Denmark
,
Niels Qvist
1   Department of Surgery, Odense University Hospital, Odense, Syddanmark, Denmark
,
Mark B. Ellebæk
1   Department of Surgery, Odense University Hospital, Odense, Syddanmark, Denmark
› Author Affiliations Funding This study was funded by the Odense University Hospital Research Foundation.
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Abstract

Introduction Treatment for long-gap esophageal atresia (LGEA) aims at achieving primary anastomosis with minimal tension. Previous studies have shown that intramural injections with botulinum toxin type-A (BTX-A) from the adventitial side can increase the elongation of the piglet and rat esophagus before bursting, and that this effect is dose and time dependent. Our aim was to determine if endoscopic injections would be feasible, safe, and with an effect on the mechanical properties of the esophagus.

Methods Twenty-two male piglets (5.15 kg) were randomized into two groups, one receiving 2 units/kg BTX-A, the other equal volume 0.9% NaCl. On day 3, the esophagus was harvested and tested in a stretch-tension machine to evaluate elongation and maximum load, followed by histological examination.

Results No adverse effects to the procedure were observed. No statistically significant difference in elongation or maximum load before bursting between the treatment and placebo group was found. In histopathological analysis, inflammation and abscess formation were observed with no statistically significant difference between the two groups.

Conclusion Endoscopic placement of BTX-A injections in the piglet esophagus was safe and feasible but did not result in any difference in the mechanical properties or histology of the esophagus.

Keywords

esophageal atresia - long gap esophageal atresia - botulinum toxin type-A - pigs


Publication History

Received: 15 September 2021

Accepted: 11 February 2022

Article published online:
10 June 2022

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Comment to this article:

Response to: Endoscopic Injections of Botulinum Toxin Type A in the Piglet Esophagus Is Safe and Feasible but Did Not Result in any Significant Structural Changes 3 Days after InjectionEur J Pediatr Surg 2023; 33(03): 255-255
DOI: 10.1055/s-0043-1767791

Comment to this article:

Endoscopic Injections of Botulinum Toxin Type A in the Piglet Esophagus Is Safe and Feasible but Did Not Result in any Significant Structural Changes 3 Days after InjectionEur J Pediatr Surg 2023; 33(03): 254-254
DOI: 10.1055/a-2039-3716

 

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