title: Antireflux role of free muscle transplantation. Experimental study in a reflux esophagitis rat model.
abstract: OBJECTIVE
  Experimental work on free muscle transplantation has resulted in some successful clinical applications. After a previous experimental study that established the viability of this procedure on the distal esophagus of the rat, we investigated the antireflux efficacy of free muscle transplantation on the distal esophagus in a reflux esophagitis rat model.
  
  
  METHODS
  Two groups of Sprague-Dawley rats were submitted to a reflux-inducing operation. Thirteen animals underwent esophagojejunostomy only (EJ) and fourteen were submitted to esophagojejunostomy plus free muscle transplantation of plantaris on the distal esophagus (ETx). Eight weeks later, the esophagi of survivors were removed after sacrifice (EJ, n = 10; ETx, n = 10) and the macroscopic longitudinal extension (mm) and the histological grade (1-4) of esophagitis evaluated.
  
  
  RESULTS
  All esophageal specimens of both groups had esophagitis. However, the extent of esophagitis (median: ETx: 23 vs EJ: 32) and the frequency of high grades of esophagitis (ETx: 30 % vs. EJ: 100 %) were significantly lower in the ETx group (p = 0.005 and p = 0.001, respectively). All except one ETx subject presented with an extent and/or a grade of esophagitis which was less than the EJ subjects' lowest values.
  
  
  CONCLUSIONS
  Experimental free muscle transplantation on the distal esophagus seems to have antireflux function, thus its therapeutic implications deserve further investigation. The incomplete efficacy of the procedure may suggest that a putative anatomic sphincter per se is not enough to promote an effective antireflux mechanism.
authors.affiliation: Division of Pediatric Surgery, Faculty of Medicine, S. João Hospital, Porto, Portugal. estevaocosta@mail.telepac.pt
authors.forename: J
authors.initials: J
authors.lastname: Estevão-Costa
authors.forename: L
authors.initials: L
authors.lastname: Morales
authors.forename: F J
authors.initials: FJ
authors.lastname: Parri
authors.forename: A
authors.initials: A
authors.lastname: Albert
mesh_terms: D000818:Animals; D004942:Esophagitis, Peptic / Q000601:surgery*; D004947:Esophagus / Q000601:surgery; D007583:Jejunum / Q000601:surgery; D008297:Male; D023421:Models, Animal; D018482:Muscle, Skeletal / Q000637:transplantation*; D051381:Rats; D017207:Rats, Sprague-Dawley; D014182:Transplantation, Autologous / Q000379:methods