title: Modified Spiral Intestinal Lengthening and Tailoring for Short Bowel Syndrome.
abstract: BACKGROUND
  The spiral intestinal lengthening and tailoring (SILT) procedure is a new surgical technique for autologous intestinal reconstruction in patients with short bowel syndrome. The aim of this work is to present a first description of a modified SILT technique by which the mucosal layer is left intact to possibly reduce the severe postoperative complications of intestinal leakage and abdominal abscess formation.
  
  
  METHODS
  The modified SILT technique was performed on a 10-cm-long intestinal segment in 2 pigs to determine the technical feasibility. Thereafter, the short-term clinical feasibility was monitored clinically in 2 dogs by gastrointestinal X-ray series at postoperative day 4 and by relaparotomy postoperative day 10.
  
  
  RESULTS
  It was technically feasible to lengthen the intestinal segment from 10 cm to 20 cm and tailoring it from 3 cm to 1.7 cm in diameter, while leaving the intestinal mucosal layer intact. The postoperative course was uneventful for both dogs. The gastrointestinal X-ray series showed an inconspicuous intestinal transit time without any signs of stricture, perforation, or leakage. In the relaparotomy, the initially achieved lengthening and tailoring extents were preserved and the operated intestinal segment was well perfused with no early signs of necrosis, stenosis, or leakage.
  
  
  CONCLUSIONS
  Leaving the mucosal layer intact during SILT is technically and clinically feasible in the short term in a large animal model. Further studies are needed to fully assess the impact of this technical modification on the long-term outcome of larger series.
authors.affiliation: University of Medical Science, Tehran, Iran.
authors.forename: Valiollah
authors.initials: V
authors.lastname: Mehrabi
authors.affiliation: Heidelberg University, Heidelberg, Germany arianeb.mehrabi@med.uni-heidelberg.de.
authors.forename: Arianeb
authors.initials: A
authors.lastname: Mehrabi
authors.affiliation: University of Medical Science, Tehran, Iran.
authors.forename: S H
authors.initials: SH
authors.lastname: Jamshidi
authors.affiliation: University of Medical Science, Tehran, Iran.
authors.forename: M S
authors.initials: MS
authors.lastname: Pedram
authors.affiliation: Tehran University of Medical Science, Shariati, Iran.
authors.forename: M S
authors.initials: MS
authors.lastname: Sabagh
authors.affiliation: Tehran University of Medical Science, Shariati, Iran.
authors.forename: N
authors.initials: N
authors.lastname: Jaberansari
authors.affiliation: Heidelberg University, Heidelberg, Germany.
authors.forename: H R
authors.initials: HR
authors.lastname: Fonouni
authors.affiliation: Tehran University of Medical Science, Shariati, Iran.
authors.forename: A H
authors.initials: AH
authors.lastname: Sharifi
authors.affiliation: Tehran University of Medical Science, Shariati, Iran.
authors.forename: R
authors.initials: R
authors.lastname: Malekzadeh
authors.affiliation: Heidelberg University, Heidelberg, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Frongia
mesh_terms: D000818:Animals; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004285:Dogs; D005240:Feasibility Studies; D005260:Female; D007422:Intestines / Q000601:surgery*; D019651:Plastic Surgery Procedures; D012778:Short Bowel Syndrome / Q000601:surgery*; D013552:Swine
keywords: Short Bowel Syndrome; Spiral Intestinal Lengthening and Tailoring; autologous intestinal reconstruction