title: A novel method of esophageal lengthening in a large animal model of long gap esophageal atresia.
abstract: OBJECTIVE
  Long gap esophageal atresia remains a significant treatment challenge. We aimed to create the first large animal model of long gap esophageal atresia to test a degradable esophageal lengthening device.
  
  
  METHODS
  The distal esophagus was divided 2 cm above the gastroesophageal junction in 6 minipigs. A polycaprolactone (PCL) spring device was secured inside the distal esophageal segment, and the end was oversewn. Nonexpanding PCL tubes served as controls. An esophagogastric anastomosis was created to restore continuity. After 4 weeks, the distal esophageal pouch was analyzed.
  
  
  RESULTS
  The distal esophageal pouch of experimental animals increased in length from 1.9 to 4.5 cm. Control animals demonstrated no change. When comparing lengthened to native esophagus, there was no difference in the thickness of muscularis mucosa or muscularis propria. Mechanically lengthened esophagus showed mild to moderate superficial inflammation and fibrosis. There were no differences in the number of myenteric or submucosal ganglia.
  
  
  CONCLUSIONS
  We created the first porcine model of long gap esophageal atresia and lengthened the distal esophagus with an internally placed device. This model may be used to explore novel therapies in the management of long gap esophageal atresia.
authors: Division of Pediatric Surgery, Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA, USA; Division of Pediatric Surgery, Department of Surgery, University of California, Los Angeles, CA, USA.
authors: Veronica F
authors: VF
authors: Sullins
authors: Department of Pathology, Harbor-UCLA Medical Center, Torrance, CA, USA.
authors: Peter K
authors: PK
authors: Traum
authors: Department of Pathology, Harbor-UCLA Medical Center, Torrance, CA, USA.
authors: Samuel W
authors: SW
authors: French
authors: Department of Bioengineering, University of California, Los Angeles, CA, USA.
authors: Benjamin M
authors: BM
authors: Wu
authors: Division of Pediatric Surgery, Department of Surgery, University of California, Los Angeles, CA, USA; Department of Bioengineering, University of California, Los Angeles, CA, USA.
authors: James C Y
authors: JC
authors: Dunn
authors: Division of Pediatric Surgery, Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA, USA; Division of Pediatric Surgery, Department of Surgery, University of California, Los Angeles, CA, USA. Electronic address: slleemd@yahoo.com.
authors: Steven L
authors: SL
authors: Lee
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D004933:Esophageal Atresia / Q000601:surgery*; D004943:Esophagogastric Junction / Q000601:surgery; D004944:Esophagoplasty / Q000295:instrumentation / Q000379:methods*; D004947:Esophagus / Q000601:surgery*; D008297:Male; D013314:Stress, Mechanical; D013552:Swine; D013556:Swine, Miniature
keywords: Animal model; Esophageal atresia; Esophageal lengthening; Long gap esophageal atresia; Pure esophageal atresia