Heller's myotomy: wound healing of iatrogenic esophagic perforation with or without pain laparoscopic fundoplication in pigs

• Grant number: 08/01396-7
• Support Opportunities: Regular Research Grants
• Start date: October 01, 2009
• End date: September 30, 2011
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Joao Luiz Moreira Coutinho de Azevedo
• Grantee: Joao Luiz Moreira Coutinho de Azevedo
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil

Abstract

AIMS: The Heller myotomy occupies a place of prominence in the treatment of achalasia of the esophagus. Meanwhile, complete perforations of the esophagus may occur during this procedure. In these circumstances, it is classically recommended the suture of drilling followed by apposition of the gastric wall under the surface of the wound caused by myotomy. However, there is experimental evidence that myotomy towards better healing when the wound is left free. The objective of this research is to assess the progress of healing in the presence of the sutured drilling in the area of laparoscopic Heller myotomy, with or without the association of a gastric patch under it. METHOD: It will be used 20 male pigs weighing between 18kg and 20kg, which will be submitted to laparoscopic Heller myotomy. A 2mm puncture will be done and immediately sutured. The animals will be equitably distributed in a group with a gastric patch over the surface of the wound caused by myotomy and a group without the gastric patch. After 21 days the animals will be sacrificed and necropsied with determining the rate of stenosis by moulding lumen of the esophageal-gastric transition. It will be held morphometric and morphologic examination of the area, including counting of collagen fibers, leukocytes and new vessels. The results will be treated by statistics. (AU)