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Capeto FA, Lima FJB, Okoba W, Ramos FL, Messias TFA, Rigonatto GA, Sbragia L, Magalhães PJC, Melo-Filho AA. Contractile profile of esophageal and gastric fundus strips in experimental doxorubicin-induced esophageal atresia. Braz J Med Biol Res 2015; 48:458-64. [PMID: 25760030 PMCID: PMC4445670 DOI: 10.1590/1414-431x20144305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 12/11/2014] [Indexed: 01/13/2023] Open
Abstract
Esophageal atresia (EA) is characterized by esophageal and gastric motility changes
secondary to developmental and postsurgical damage. This study evaluated the
in vitro contractile profile of the distal esophagus and gastric
fundus in an experimental model of EA induced by doxorubicin (DOXO). Wistar pregnant
rats received DOXO 2.2 mg/kg on the 8th and 9th gestational days. On day 21.5,
fetuses were collected, sacrificed, and divided into groups: control, DOXO without EA
(DOXO-EA), and DOXO with EA (DOXO+EA). Strips from the distal esophagus and gastric
fundus were mounted on a wire myograph and isolated organ-bath system, respectively,
and subjected to increasing concentrations of carbamylcholine chloride (carbachol,
CCh). The isolated esophagus was also stimulated with increasing concentrations of
KCl. In esophagus, the concentration-effect curves were reduced in response to CCh in
the DOXO+EA and DOXO-EA groups compared to the control group (P<0.05). The maximum
effect values (Emax) for DOXO+EA and DOXO-EA were significantly lower than
control (P<0.05), but the half-maximal effective concentration (EC50)
values were not significantly different when the three groups were compared
(P>0.05). In response to KCl, the distal esophagus samples in the three groups
were not statistically different with regard to Emax or EC50
values (P>0.05). No significant difference was noted for EC50 or
Emax values in fundic strips stimulated with CCh (P>0.05). In
conclusion, exposure of dams to DOXO during gestation inhibited the contractile
behavior of esophageal strips from offspring in response to CCh but not KCl,
regardless of EA induction. The gastric fundus of DOXO-exposed offspring did not have
altered contractile responsiveness to cholinergic stimulation.
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Affiliation(s)
- F A Capeto
- Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - F J B Lima
- Departamento de Fisiologia e Farmacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - W Okoba
- Departamento de Fisiologia e Farmacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - F L Ramos
- Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - T F A Messias
- Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - G A Rigonatto
- Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - L Sbragia
- Departamento de Cirurgia e Anatomia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - P J C Magalhães
- Departamento de Fisiologia e Farmacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - A A Melo-Filho
- Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
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Tovar JA, Fragoso AC. Current Controversies in the Surgical Treatment of Esophageal Atresia. Scand J Surg 2011; 100:273-278. [DOI: 10.1177/145749691110000407] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Background and Aims:Esophageal atresia (EA) with or without tracheo-esophageal fistula (TEF) is a rare condition that can be nowadays succesfully treated. The current interest therefore is focused on the management of the difficult cases, on thoracoscopic approach, and on some aspects of the long-term results.Methods:The current strategies for the difficult or impossible anastomoses in pure and long-gap EA, the introduction of thoracoscopic repair and the causes, mechanisms and management of post-operative gastro-esophageal reflux (GER) are reviewed.Results:Methods of esophageal elongation and multi-staged repair of pure and long-gap EA allow anastomosis but with functional results that are often poor. Esophageal replacement with colon or stomach achieves at least similar results and often requires less procedures. Thoracoscopic repair is a promising adjunct, but the difficulties for setting it as a gold-standard are pointed out. GER is a part of the disease and its surgical treatment, that is often required, is burdened by high failure rates.Conclusions:EA with or without TEF can be successfully treated in most cases, but a number of unsolved issues remain and the current approach to difficult cases will certainly evolve in the future.
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Affiliation(s)
- J. A. Tovar
- Department of Pediatric Surgery, Hospital Universitario La Paz and Universidad Autonoma de Madrid, Madrid, Spain
| | - A. C. Fragoso
- Department of Pediatric Surgery, Hospital Universitario La Paz and Universidad Autonoma de Madrid, Madrid, Spain
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Tugay M, Yildiz F, Utkan T, Sarioglu Y, Gacar N. Gastric smooth muscle contractility changes in the esophageal atresia rat model: an in vitro study. J Pediatr Surg 2003; 38:1366-70. [PMID: 14523821 DOI: 10.1016/s0022-3468(03)00397-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
PURPOSE The aim of the study was to investigate the gastric smooth muscle reactivity in the Adriamycin-induced esophageal atresia (EA) rat model. METHODS The fetuses were divided into 3 groups. The control group was exposed to saline. The second group was comprised of fetuses that were exposed to Adriamycin but did not have EA (Adriamycin-no-EA group). The third group was comprised of fetuses that were exposed to Adriamycin and had EA (Adriamycin-EA group). Gastric fundus strips were studied in vitro for their contractile response to receptor activation in the 3 groups. RESULTS Contractile responses of gastric smooth muscle to carbachol and KCl were increased in the Adriamycin-EA group compared with the Adriamycin-no-EA group. Also serotonin-induced contractile response in the Adriamycin-EA group decreased compared with the Adriamycin-no-EA group. Relaxation of gastric smooth muscle strips to isoproterenol was comparably unaffected in the Adriamycin-EA and Adriamycin-no-EA groups. Likewise, no change in the response to agonist studies was observed between the control and Adriamycin-no-EA groups. The relaxant response to papaverine was not different in the 3 groups. CONCLUSIONS This study found changes of receptor-dependent and receptor-independent contraction of the gastric fundus smooth muscle in the fetuses with EA. Therefore, impaired contractile responses may be, at least in part, a contributing factor in the abnormal gastric motility seen in EA.
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