An experimental animal model of intestinal obstruction to simulate in utero therapy for jejunoileal atresia.
OBJECTIVE
To obtain 'intestinal atresia-like' conditions in the fetal lamb model to subsequently allow in utero surgical repair.


METHODS
Six time-dated pregnant sheep underwent general anesthesia at 75 days of gestation (term 145 +/- 5 days). After maternal laparotomy and hysterotomy, the fetal abdomen was opened. Once the jejunoileal intestinal loop was identified, the mesenteric vessels were isolated, ligated, and sectioned in 2 fetuses, and in the remaining 5 fetuses the bowel loop was ligated. Two further fetuses were used as controls and underwent sole laparotomy. Of the group of 7 fetuses 2 were reoperated at 100-105 days of gestational age and underwent intestinal recanalization. Eight fetuses were delivered at term by cesarean section and the remaining 1 by spontaneous delivery. One newborn underwent neonatal entero-enteric anastomosis.


RESULTS
4 out of 6 fetuses survived, in utero intestinal or vascular ligation having provoked an 'intestinal atresia-like' picture. The animal operated at birth died. The 2 control fetuses and the 2 fetuses with in utero intestinal recanalization survived until term.


CONCLUSIONS
The present study shows that in utero treatment of intestinal obstruction is possible in an experimental model.
Patricolo
M
M
Department of Pediatric Surgery, Ospedale Pediatrico Bambino Gesù, Rome.
Noia
G
G
Rossi
L
L
Zangari
A
A
Pomini
F
F
Catesini
C
C
Filippetti
R
R
Galli
T
T
Iacobelli
B D
BD
Capuano
L G
LG
Romano
D
D
Mancuso
S
S
Rivosecchi
M
M
D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D005315:Fetal Diseases / Q000601:surgery*; D007082:Ileum / Q000002:abnormalities / Q000601:surgery; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D007583:Jejunum / Q000002:abnormalities / Q000601:surgery; D008026:Ligation; D011247:Pregnancy; D012756:Sheep