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The Effect of Intramural Botulinum Toxin Injections on the Elongation of the Piglet Oesophagus Is Time Dependent.
European Journal of Pediatric Surgery 2017 Februrary
Introduction One in 4,000 infants is born with oesophageal atresia. Approximately 15% of these have a long gap oesophageal atresia, where primary anastomosis is difficult or impossible. Previous studies have shown an effect of intramural botulinum toxin type A (BTX-A) injections on the elongation and max load of the esophagus 1 hour after injection. We hypothesized that a longer waiting period of 2 hours could increase this effect. Methods Forty-five piglets were randomized into three groups. Two treatment groups received 2 units/kg of BTX-A and one group received saline. After 1 or 2 hours, a segment of the esophagus was harvested and put in a stretch-tension device to assess elongation and max load. Results Elongation from preload to max load and percentage elongation in the BTX-A 2h group (17.09 mm, 46.46%) was significantly higher compared with the BTX-A 1h group (13.59 mm, 40.16%) and the placebo group (13.77 mm, 39.92%). Conclusion Elongation of the piglet esophagus was significantly improved with a 2-hour waiting period after BTX-A injection. Injections with BTX-A could be useful in oesophageal atresia, where primary anastomosis is not possible.
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