[Peroral endoscopic full and partial-thickness myotomy. A viability study in an animal model]. / Miotomía endoscópica por vía oral de espesor total y parcial. Estudio de factibilidad en un modelo animal.

BACKGROUND: Peroral endoscopic myotomy has recently been developed and performed on patients with good results. AIMS: To evaluate the technical feasibility of peroral endoscopic full-thickness and partial thickness myotomy in a porcine model. MATERIAL AND METHODS: Eighteen criollo pigs were randomly assigned to 2 groups: group A (partial-thickness myotomy) and group B (full-thickness myotomy). The mucosal defect proximal to the myotomy site was left open. On the seventh postoperative day the pig was euthanized and follow-up surgical exploration was performed. The duration of each procedure, postoperative progression of the animal, complications, and anatomopathologic findings were registered. RESULTS: The procedure was viable in all the pigs. The mean surgery duration was 81±35.3min (group A 51.11±11.12, group B 111±22.61; P<.05). The main complication during myotomy was subcutaneous emphysema (16%). The histopathologic study of the group A surgical specimens reported complete circular myotomy in all cases, and complete circular and longitudinal myotomy was reported in 100% of the group B sample. CONCLUSIONS: The endoscopic myotomy technique is feasible. Endoscopic partial-thickness myotomy was associated with shorter surgery duration and better results during the intraoperative period and the 7-day follow-up.

[Usefulness of chewing gum for the resolution of postoperative ileus in left colon resections]. / Utilidad de la goma de mascar para la resolución del íleo posoperatorio en resecciones de colon izquierdo.

BACKGROUND AND AIM: Disturbances in intestinal motility have been described since XIX century, with a not very well understood pathogenesis and few therapeutic approaches. Considering chewing as an important stimulus to promote intestinal motility we designed this study to assess the efficacy of chewing gum to improve the postoperative ileus, and the clinical relevance of this intervention. METHODS: Were included patients who underwent for elective left hemicolectomy during January 2007 to December 2008. The patients were randomly assigned to receive chewing gum or nothing during the post-surgery period. The main outcomes assessed were duration of postoperative ileus, and reduction in hospitalization days. RESULTS: During the period of the study were included 32 patients, were included mainly men (11 and 9 in treated and control patients, respectively). The first defecation after surgery procedure occurs at (44.2 ± 17.6 h) in the treated group and (55.5 ± 14.8 h) in the control group (p = 0.05). In the same way oral tolerance was achieved faster in the treated group (p= 0.05). The hospital stay duration was not different among treated and not treated patients. CONCLUSIONS: The use of chewing gum in patients after elective left hemicolectomy, reduce the duration of the postoperative ileus. However, this does not reduce the hospital stay duration.