INTRODUCTION  Treatment for long-gap esophageal atresia (LGEA) aims at achieving primary anastomosis with minimal tension. Previous studies have shown that intramural injections with botulinum toxin type-A (BTX-A) from the adventitial side can increase the elongation of the piglet and rat esophagus before bursting, and that this effect is dose and time dependent. Our aim was to determine if endoscopic injections would be feasible, safe, and with an effect on the mechanical properties of the esophagus. METHODS  Twenty-two male piglets (5.15 kg) were randomized into two groups, one receiving 2 units/kg BTX-A, the other equal volume 0.9% NaCl. On day 3, the esophagus was harvested and tested in a stretch-tension machine to evaluate elongation and maximum load, followed by histological examination. RESULTS  No adverse effects to the procedure were observed. No statistically significant difference in elongation or maximum load before bursting between the treatment and placebo group was found. In histopathological analysis, inflammation and abscess formation were observed with no statistically significant difference between the two groups. CONCLUSION  Endoscopic placement of BTX-A injections in the piglet esophagus was safe and feasible but did not result in any difference in the mechanical properties or histology of the esophagus.

中文翻译：

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内镜下向仔猪食道注射 A 型肉毒杆菌毒素是安全可行的，但注射后 3 天没有导致任何显着的结构变化。

引言 长间隙食管闭锁（LGEA）的治疗旨在以最小张力实现初次吻合。先前的研究表明，从外膜侧壁内注射A型肉毒毒素（BTX-A）可以增加仔猪和大鼠食管破裂前的伸长，并且这种效果具有剂量和时间依赖性。我们的目的是确定内窥镜注射是否可行、安全以及对食道机械性能的影响。方法 将22头雄性仔猪（5.15 kg）随机分为两组，一组接受2单位/kg BTX-A，另一组接受等体积的0.9% NaCl。第3天，收获食管并在拉伸张力机中进行测试以评估伸长率和最大负载，然后进行组织学检查。结果 没有观察到对手术的不利影响。治疗组和安慰剂组之间的伸长率或爆裂前最大负荷没有发现统计学上的显着差异。组织病理学分析中观察到炎症和脓肿形成，两组之间无统计学差异。结论 内镜下将 BTX-A 注射液置于仔猪食管中是安全可行的，但不会导致食管的机械特性或组织学发生任何差异。