Understanding endoluminal gastroplications: a histopathologic analysis of intraluminal suture plications

Gastrointestinal Endoscopy
Arnaldo B FeitozaAlan R Zinsmeister

Abstract

Endoluminal gastroplication is used to treat GERD, with modest results. Little is known of the histologic reaction to endosutures. Thus, the histologic response to intraluminal plications at different penetration depths within the gastric wall was studied in an animal model. Intraluminal gastroplications were performed through a laparotomy in 18 New Zealand rabbits. Three sets of everted plications were placed at different penetration depths in each stomach: submucosa (SMpl), muscularis propria (Mpl), and serosa (Spl). Animals were randomized to survival times of 3, 10, or 60 days (respectively, Groups I, II, and III). Plications were compared with a grade scale for each histologic healing phase and gross inspection. Fusion between folds was absent in all groups. Serosa differed from muscularis propria with respect to the proportion of samples with microscopic ischemia (67% vs. 8%; p = 0.015), remaining sutures in Group III (33% vs. 3%; p < 0.05 in a single test of significance, but correction for multiple testing removes this significance), and remaining plications in Group II (96% vs. 54%; p < 0.05 in a single test of significance, but correction for multiple testing removes this significance). All of the total and partial hi...Continue Reading

Citations

Mar 30, 2004·The American Journal of Gastroenterology·Joel E Richter
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May 24, 2006·World Journal of Gastroenterology : WJG·Atif IqbalCharles-J Filipi
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Dec 28, 2006·Minimally Invasive Therapy & Allied Technologies : MITAT : Official Journal of the Society for Minimally Invasive Therapy·Michele MarcheseGuido Costamagna
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Mar 18, 2006·The American Journal of Gastroenterology·Julia J LiuJohn R Saltzman
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Feb 11, 2005·Current Opinion in Gastroenterology·Wahid Wassef

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