title: [New technique for intestinal lengthening -- from the idea to the clinical application].
abstract: BACKGROUND
  In severe short bowel syndrome, as a result of the natural adaptation, the bowel becomes overdilated, this interferes with the persitalsis and may lead to stasis, bacterial translocation and sepsis. At present two techniques are used to improve peristalsis. The Bianchi procedure is technically challenging, the Serial Transverse Enteroplasty (STEP) is easy however it results in an aphysiological ultrastructure altering the orientation of the muscle fibres. Our aim was to develop an easy technique, which does not alter intestinal muscular ultrastructure dramatically.
  
  
  METHODS
  The idea, Spiral Intestinal Lengthening and Tailoring (SILT), is based on a spiral shape incision of the intestine and retubularisation in a longer but narrower fashion. The feasibility and the effect on the muscular ultrastructure were tested on bowelsimulator and porcine intestine. The intramural microcirculation was checked with intravital microscopy. The outcome was assessed on minipigs (n = 6) than clinical application was commenced.
  
  
  RESULTS
  SILT was feasible, did not change the orientation of muscle fibres significantly, did not compromised microcirculation, no surgical complication was noted when tailoring did not exceed 75%. The first clinical application was successful.
  
  
  CONCLUSIONS
  SILT is a safe and easy technique and not altering the intestinal musculature significantly.
authors.affiliation: Szegedi Tudományegyetem Sebészeti Műtéttani Intézet 6720 Szeged Pécsi u. 6. Jósa András Megyei Kórház Gyermekosztály Nyíregyháza Royal Manchester Children's University Hospital United Kingdom.
authors.forename: Tamás
authors.initials: T
authors.lastname: Cserni
authors.affiliation: Szegedi Tudományegyetem Sebészeti Műtéttani Intézet 6720 Szeged Pécsi u. 6.
authors.forename: Garbriella
authors.initials: G
authors.lastname: Varga
authors.affiliation: Szegedi Tudományegyetem Sebészeti Műtéttani Intézet 6720 Szeged Pécsi u. 6.
authors.forename: Dániel
authors.initials: D
authors.lastname: Erces
authors.affiliation: Szegedi Tudományegyetem Sebészeti Műtéttani Intézet 6720 Szeged Pécsi u. 6.
authors.forename: József
authors.initials: J
authors.lastname: Kaszaki
authors.affiliation: Jósa András Megyei Kórház Gyermekosztály Nyíregyháza.
authors.forename: Beáta
authors.initials: B
authors.lastname: Biszku
authors.affiliation: Jósa András Megyei Kórház Gyermekosztály Nyíregyháza.
authors.forename: Ildikó
authors.initials: I
authors.lastname: Guthy
authors.affiliation: Jósa András Megyei Kórház Gyermekosztály Nyíregyháza.
authors.forename: Agnes
authors.initials: A
authors.lastname: László
authors.affiliation: Jósa András Megyei Kórház Gyermekosztály Nyíregyháza.
authors.forename: Ferenc
authors.initials: F
authors.lastname: Dicső
authors.affiliation: Royal Manchester Children's University Hospital United Kingdom.
authors.forename: Adrian
authors.initials: A
authors.lastname: Bianchi
authors.affiliation: Royal Manchester Children's University Hospital United Kingdom.
authors.forename: Antonino
authors.initials: A
authors.lastname: Morabito
authors.affiliation: Royal Manchester Children's University Hospital United Kingdom.
authors.forename: György
authors.initials: G
authors.lastname: Rákóczy
mesh_terms: D000818:Animals; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005240:Feasibility Studies; D007421:Intestine, Small / Q000098:blood supply* / Q000503:physiopathology / Q000601:surgery*; D008833:Microcirculation; D023421:Models, Animal; D010528:Peristalsis; D012778:Short Bowel Syndrome / Q000503:physiopathology / Q000601:surgery*; D013552:Swine
keywords: new lengthening technique; rövidbél-szindróma; short bowel; új bélhosszabbító műtét