Peroral endoscopic full and partial-thickness myotomy. A viability study in an animal model

• Main Authors: C.D. Quiroz-Guadarrama, M. Rojano-Rodríguez, J.J. Herrera-Esquivel, F. de la Concha-Bermejillo, L.S. Romero-Loera, I. Estrada-Moscoso, I. del Rio-Suarez, J.M. Morales-Vargas, M.F. Torres-Ruiz, J.A. Gonzalez-Angulo, J.L. Beristain-Hernandez, J. Alonso-Lárraga, E. Cárdenas-Lailson, M. Moreno-Portillo
• Format: Article
• Language: English
• Published: Elsevier 2013-10-01
• Series: Revista de Gastroenterología de México (English Edition)
• Subjects: Peroral endoscopic myotomy; Peroral endoscopic full-thickness myotomy; Peroral endoscopic partial-thickness myotomy; Porcine model
• Online Access: http://www.sciencedirect.com/science/article/pii/S2255534X14000061

Background: Peroral endoscopic myotomy has recently been developed and performed on patients with good results. Aims: To evaluate the technical feasibility of peroral endoscopic full-thickness and partial thickness myotomy in a porcine model. Material and methods: Eighteen criollo pigs were randomly assigned to 2 groups: group A (partial-thickness myotomy) and group B (full-thickness myotomy). The mucosal defect proximal to the myotomy site was left open. On the seventh postoperative day the pig was euthanized and follow-up surgical exploration was performed. The duration of each procedure, postoperative progression of the animal, complications, and anatomopathologic findings were registered. Results: The procedure was viable in all the pigs. The mean surgery duration was 81 ± 35.3 min (group A 51.11 ± 11.12, group B 111 ± 22.61; P < .05). The main complication during myotomy was subcutaneous emphysema (16%). The histopathologic study of the group A surgical specimens reported complete circular myotomy in all cases, and complete circular and longitudinal myotomy was reported in 100% of the group B sample. Conclusions: The endoscopic myotomy technique is feasible. Endoscopic partial-thickness myotomy was associated with shorter surgery duration and better results during the intraoperative period and the 7-day follow-up.