Magno Priscilla, Khashab Mouen A, Mas Manuel, Giday Samuel A, Buscaglia Jonathan M, Shin Eun Ji, Dray Xavier, Kalloo Anthony N
Division of Gastroenterology and Hepatology, University of Puerto Rico School of Medicine, San Juan, PR 00936, USA.
Minim Invasive Surg. 2012;2012:365814. doi: 10.1155/2012/365814. Epub 2012 May 24.
Background. NOTES techniques allow transesophageal access to the mediastinum. The aim of this study was to assess the feasibility of transesophageal biopsy of thoracic vertebrae. Methods. Nonsurvival experiments on four 50-kg porcine animals were performed. Transesophageal access to the mediastinum was attained using submucosal tunneling technique. Results. The posterior mediastinum was successfully accessed and navigated in all animals. Vertebral bodies and intervertebral spaces were easily approached while avoiding damage to adjacent vessels. Bone biopsy was successfully performed without complications, but the hardness of bone tissue resulted in small and fragmented samples. Conclusions. Peroral transesophageal access into the posterior mediastinum and thoracic vertebral bone biopsy was feasible and safe. The proximity of the esophagus to the vertebral column provides close and direct access to the thoracic spine and opens up new ground for the performance of multilevel anterior spine procedures using NOTES techniques.
背景。NOTES技术允许经食管进入纵隔。本研究的目的是评估经食管对胸椎进行活检的可行性。方法。对4只50千克的猪进行非存活实验。采用黏膜下隧道技术经食管进入纵隔。结果。所有动物均成功进入并探查了后纵隔。在避免损伤相邻血管的同时，椎体和椎间隙很容易到达。成功进行了骨活检，无并发症发生，但骨组织的硬度导致样本小且破碎。结论。经口经食管进入后纵隔和胸椎骨活检是可行且安全的。食管与脊柱的接近为直接接近胸椎提供了便利，并为使用NOTES技术进行多级前路脊柱手术开辟了新领域。
