Department of Medicine and Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USS.
Endoscopy. 2014 Jul;46(7):605-9. doi: 10.1055/s-0034-1365406. Epub 2014 Apr 25.
Endoscopic submucosal dissection (ESD) is a technically challenging procedure. A novel gel can facilitate ESD due to its submucosal dissecting properties. This prospective porcine survival study evaluated clinical and histologic parameters of hybrid ESD using the gel.
Gastric submucosal lesions were created in six pigs and hybrid ESD was performed. Healing was assessed weekly until necropsy at Day 28.
En bloc resection was achieved in all lesions (mean size 40.7 mm). The mean total procedure time was 13.5 minutes and the mean resection time was 5.5 minutes. The mean total histologic injury score was 4. At necropsy, four ulcers had healed completely and two were < 6 mm in size.
Hybrid ESD of large gastric lesions in a porcine model can be facilitated by the novel gel, dramatically reducing procedure and resection times by eliminating the need for time-consuming submucosal dissection. The novel gel is safe and easy to use, and has the potential to simplify ESD. Further prospective human studies are needed to validate these findings.
内镜黏膜下剥离术（ESD）是一项技术要求很高的操作。一种新型凝胶具有黏膜下分离特性，有助于 ESD。本前瞻性猪存活研究使用该凝胶评估了混合 ESD 的临床和组织学参数。
在六头猪的胃黏膜下病变处进行混合 ESD。每周评估愈合情况，直到第 28 天尸检。
所有病变均达到整块切除（平均大小 40.7 毫米）。平均总手术时间为 13.5 分钟，平均切除时间为 5.5 分钟。平均总组织学损伤评分 4 分。尸检时，4 个溃疡完全愈合，2 个溃疡<6 毫米。
新型凝胶可促进大型猪胃病变的混合 ESD，通过消除耗时的黏膜下剥离，显著缩短手术和切除时间。新型凝胶安全易用，有简化 ESD 的潜力。需要进一步的前瞻性人体研究来验证这些发现。
