The second STEP: the feasibility of repeat serial transverse enteroplasty

Hannah Piper, Biren P. Modi, Heung Bae Kim, Dario Fauza, John Glickman, Tom Jaksic

Research output: Contribution to journalArticle

47 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1951-1956
Number of pages6
JournalJournal of Pediatric Surgery
Volume41
Issue number12
DOIs
StatePublished - Dec 1 2006

Keywords

  • Bowel dilation
  • Bowel lengthening
  • Intestinal failure
  • STEP
  • Serial transverse enteroplasty

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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