Abstract
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.
Keywords
botulinum toxin type A - esophageal atresia - pigs
