Document Detail

In utero repair of gastroschisis in the sheep (Ovis aries) model.
MedLine Citation:
PMID:  20105581     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: In utero anatomic repair of gastroschisis is possible in mid-gestation in the fetal lamb model, and it appears to ameliorate the inflammatory process.
Jacob T Stephenson; Kullada O Pichakron; Lan Vu; Tim Jancelewicz; Ramin Jamshidi; J Kevin Grayson; Kerilyn K Nobuhara
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  45     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-28     Completed Date:  2010-03-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  65-9     Citation Subset:  IM    
Copyright Information:
Copyright 2010. Published by Elsevier Inc.
Fetal Treatment Center, Pediatric Surgery Department University of California, San Francisco, San Francisco, CA 94143-0570, USA.
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MeSH Terms
Abdominal Wall / abnormalities,  surgery
Disease Models, Animal
Fetus / surgery*
Gastroschisis / pathology,  surgery*
Gestational Age
Intestines / pathology,  surgery
Reconstructive Surgical Procedures / methods
Sheep, Domestic

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