Repairing large duodenal injuries in dogs by expanded polytetrafluoroethylene patch.
BACKGROUND
One of the most challenging problems in clinical surgery is management of injured duodenum. In this experimental study, we treated large duodenal defects by an expanded polytetrafluoroethylene (ePTFE, Gore-Tex; W.L. Gore, Elkton, MD) soft-tissue patch and compared it with the jejunal serosal patch.


METHODS
A duodenal defect (about 50% of the total circumference) was created in the second portion of the duodenum in 20 dogs. The effectiveness and gross and histological examinations of the ePTFE patch technique was compared with the jejunal serosal patch.


RESULTS
No significant difference was found in early survival rates (90.9% versus 88.9%; P = 0.711). The whole grafted area was covered by neomucosa at the end of the sixth week in all animals with the ePTFE patch. The scar was small; no significant narrowing of lumen was noted and serosal healing was uniformly complete. In histological examination, complete coverage of the ePTFE grafts by neomucosa consisting of columnar epithelium with short villous formations was observed.


CONCLUSIONS
Use of the ePTFE patch method is easy, reliable, and comparable to the jejunal serosal patch. It can be used in the treatment of large duodenal defects, which cannot be repaired by duodenorraphy.
Nikeghbalian
Saman
S
Shiraz Organ Transplantation Center, Nemazee Hospital, Shiraz, Iran. transpln@sums.ac.ir
Atefi
Sohrab
S
Kazemi
Kourosh
K
Jalaeian
Hamed
H
Roshan
Naghmeh
N
Naderi
Naser
N
Hajizadeh
Reza
R
Tanideh
Nader
N
D000818:Animals; D013505:Digestive System Surgical Procedures / Q000379:methods* / Q000401:mortality; D004195:Disease Models, Animal; D004285:Dogs; D004386:Duodenum / Q000293:injuries* / Q000601:surgery*; D007583:Jejunum / Q000601:surgery; D011138:Polytetrafluoroethylene; D012704:Serous Membrane / Q000601:surgery; D013526:Surgical Mesh; D015996:Survival Rate; D014945:Wound Healing
D011138:Polytetrafluoroethylene