Endoscopy Unit, Hospital Clínic, CIBERehd, Barcelona 08026, Spain.
World J Gastroenterol. 2011 Apr 7;17(13):1732-8. doi: 10.3748/wjg.v17.i13.1732.
To evaluate the feasibility, reproducibility and efficacy of a new tissue anchoring device in a porcine survival model.
Gastrotomies were performed using a needle-knife and balloon dilator in 10 female Yorkshire pigs weighing 30-35 kg. Gastric closure was attempted using a new tissue anchoring device. The tightness of the closure was confirmed by means of air insufflation and the ability to maintain gastric distension with stability in peritoneal pressure measured with a Veress needle. All animals were monitored daily for signs of peritonitis and sepsis over 14 d. During necropsy, the peritoneal cavity and the gastric access site were examined.
Transgastric access, closure and 14 d survival was achieved in all pigs. The mean closure time was 18.1 ± 19.2 min and a mean of 2.1 ± 1 devices were used. Supplementary clips were necessary in 2 cases. The closure time was progressively reduced (24.8 ± 13.9 min in the first 5 pigs vs 11.4 ± 5.9 min in the last 5, P = NS). At necropsy, the gastric access site was correctly closed in all cases with all brace-bars present. One device was misplaced in the mesocolon. Minimal adhesions were observed in 3 pigs and signs of mild peritonitis and adhesions in one.
The use of this new tissue anchoring device in porcine stomachs is feasible, reproducible and effective and requires a short learning curve.
评估一种新型组织锚定装置在猪存活模型中的可行性、可重复性和疗效。
在 10 只体重 30-35 公斤的雌性约克夏猪中，使用针刀和球囊扩张器进行胃造口术。尝试使用新型组织锚定装置关闭胃。通过空气充气和 Veress 针测量的稳定腹膜压力来维持胃扩张来确认闭合的紧密性。所有动物在 14 天内每天监测腹膜炎和败血症的迹象。在尸检时，检查腹膜腔和胃进入部位。
所有猪均实现了经胃进入、闭合和 14 天存活。平均闭合时间为 18.1±19.2 分钟，平均使用 2.1±1 个装置。在 2 例中需要补充夹。闭合时间逐渐缩短（前 5 例为 24.8±13.9 分钟，后 5 例为 11.4±5.9 分钟，P=NS）。尸检时，所有支撑棒均存在的情况下，胃进入部位在所有情况下均正确闭合。一个装置错位到系膜中。3 只猪观察到最小的粘连，1 只猪有轻度腹膜炎和粘连的迹象。
在猪胃中使用这种新型组织锚定装置是可行的、可重复的和有效的，并且需要较短的学习曲线。
