The repair of a large duodenal defect by a pedicled gastric seromuscular flap.
OBJECTIVE
The aim was to evaluate the efficacy of a pedicled gastric seromuscular flap for the closure of a large duodenal defect.


METHODS
A large defect of the second duodenal part was repaired by a gastric seromuscular flap. Of 35 rats, 9 rats were euthanized at 2 weeks, 12 rats at 2 months, and 14 rats at 4 months for the histopathological evaluation of the patch and normal duodenum (control) adjacent to the patch.


RESULTS
All rats survived. The patch was completely covered by neomucosa in all of the 4-month rats, and in 8 of the 12 2-month rats. The villous height of the neomucosa was significantly higher in the 4-month rats in comparison to the other rats (P < 0.001). However, a normal duodenum had higher villi than in that of the patches (P < 0.001). The crypt density of the neomucosa was significantly increased in the 4-month rats in comparison to the 2-week and the 2-month rats (P < 0.001 and P < 0.05 group, respectively). The crypt density was higher in the controls than in the neomucosa covered patch of the 2-week and the 2-month rats (P < 0.001 and P < 0.05, respectively). The crypt depth of the neomucosa increased significantly in the 4-month rats and in the controls versus the 2-week rats (P < 0.05).


CONCLUSIONS
The new mucosal barrier overlaying the patch appeared to be satisfactory. This technique, which has not been described previously, is likely to be useful for the repair of the large duodenal defect.
Aslan
Adnan
A
Department of Pediatric Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
Elpek
Ozlem
O
D000704:Analysis of Variance; D000714:Anastomosis, Surgical; D000818:Animals; D016009:Chi-Square Distribution; D013505:Digestive System Surgical Procedures / Q000379:methods; D004386:Duodenum / Q000293:injuries / Q000601:surgery*; D005260:Female; D005753:Gastric Mucosa / Q000637:transplantation; D023421:Models, Animal; D051381:Rats; D017208:Rats, Wistar; D013524:Surgical Flaps / Q000473:pathology; D016896:Treatment Outcome; D014945:Wound Healing