In utero repair of gastroschisis in the sheep (Ovis aries) model

Journal of Pediatric Surgery
Jacob T StephensonKerilyn K Nobuhara

Abstract

Gastroschisis is associated with inflammatory changes in the exposed bowel which leads to intestinal dysmotility after postnatal repair. The insult is a combined effect of amniotic fluid exposure and mechanical constriction. We hypothesized that in utero anatomic repair is possible in a sheep model, and that it may halt the inflammatory damage caused by both mechanisms. Gastroschisis was surgically created in mid-gestation (day 75) in 8 sheep fetuses. On gestational day 100, 2 fetuses underwent open fetal gastroschisis repair, where the eviscerated bowel was returned to the peritoneal cavity, and the abdominal wall was primarily closed. All fetuses were harvested at 135 days of gestation. Six fetuses survived the initial operation, and both fetuses that underwent gastroschisis repair survived to term. At 100 and 135 days of gestation, the eviscerated bowel showed progressive signs of inflammation and peel development. The gross and microscopic inflammatory changes in the gastroschisis bowel at 100 days of gestation were completely resolved at term following in utero repair. In utero anatomic repair of gastroschisis is possible in mid-gestation in the fetal lamb model, and it appears to ameliorate the inflammatory process.

References

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Citations

Dec 20, 2011·Surgical Endoscopy·Robert BergholzKurt Hecher
Jan 1, 2014·Prenatal Diagnosis·Karine LepigeonDavid Baud
Mar 14, 2013·Journal of Pediatric Surgery·Luc A J RoelofsRené M H Wijnen
Mar 15, 2014·Acta Cirúrgica Brasileira·Cervantes CaporossiJosé Eduardo de Aguilar-Nascimento
May 18, 2019·Biomaterials Science·Sally M WinklerPhillip B Messersmith
Jun 3, 2020·NeoReviews·Bethany J Slater, Ashwin Pimpalwar
Dec 17, 2020·Journal of Clinical Medicine·Andreas MeinzerRobert Bergholz
Apr 30, 2021·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Robert BergholzThomas Krebs

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