Chen W-H, Chu Y, Wu Y-C, Liu C-Y, Yuan H-C, Ko P-J, Liu Y-H
Laboratory Animal Center, Department of Surgery, Chang Gung Memorial Hospital, Linko, Chang Gung University, Guei-Shan Shiang, Taiwan, ROC.
Eur Surg Res. 2012;48(1):26-33. doi: 10.1159/000334281. Epub 2011 Dec 22.
An ideal wound closure device would repair the wound with minimal complexity. In this report, we describe a simple wound closure method using BioGlue sealant.
Eleven canines underwent transtracheal pericardial window creation under endoscopic guidance for natural orifice transluminal endoscopic surgery (NOTES). The tracheal wound was closed using BioGlue sealant. The integrity of the wound was assessed by determining the amount of air leaking under mechanical ventilation.
Transtracheal thoracic exploration and pericardial window creation was successful for all of the canines, and adequate wound closure was achieved in 10 of the canines. There was 1 case of NOTES-related death arising from misplacement of the endotracheal tube in the left lower lobar bronchus. This caused a collapse of the left upper lobe and ventilatory failure. Minor lung injuries occurred in 3 canines and minor mediastinal bleeding was encountered in 1 canine during the creation of the access site.
BioGlue sealant was found to be effective in sealing the tracheal wound in all but 1 of the canines. This study demonstrates that the use of the sealant is a simple and efficient means of endoscopically closing the tracheal access site in NOTES.
理想的伤口闭合装置应以最小的复杂性修复伤口。在本报告中，我们描述了一种使用生物胶水密封剂的简单伤口闭合方法。
11只犬在内镜引导下进行经气管心包开窗术，用于自然腔道内镜手术（NOTES）。气管伤口用生物胶水密封剂闭合。通过测定机械通气时漏气量评估伤口的完整性。
所有犬经气管胸腔探查和心包开窗术均成功，10只犬实现了充分的伤口闭合。有1例NOTES相关死亡，原因是气管插管误置于左下叶支气管，导致左上叶肺萎陷和呼吸衰竭。在建立进入部位过程中，3只犬发生轻微肺损伤，1只犬出现轻微纵隔出血。
发现生物胶水密封剂对除1只犬外的所有犬的气管伤口密封均有效。本研究表明，使用密封剂是在内镜下闭合NOTES中气管进入部位的一种简单而有效的方法。
