Schölvinck D W, Belghazi K, Pouw R E, Curvers W L, Weusten B L A M, Bergman J J G H M
Department of Gastroenterology and Hepatology, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands.
Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
Surg Endosc. 2016 Feb;30(2):471-479. doi: 10.1007/s00464-015-4222-x. Epub 2015 May 28.
Multiband mucosectomy (MBM) is widely used for the endoscopic resection of early neoplasia in the upper gastrointestinal tract. A new MBM-device may have advantages over the current MBM-device with improved visualization, easier passage of accessories, and higher suction power due to different trip wire and cap.
Rubber bands were released one by one for both MBM-devices while endoscopic images were collected. First, free endoscopic view was assessed by computer-assisted measurements (quantitative) and by ranking the images by a panel of 11 endoscopists (qualitative). Second, using a visual analog scale, three 'blinded' endoscopists assessed introduction and advancement of three types of endoscopic devices through the working channel of a diagnostic endoscope with the MBM-devices assembled. Third, suction power was evaluated by a manometer attached to the cap of the assembled MBM-devices in four endoscopes. Negative pressures were measured after 5 and 10 s of suction and repeated five times. The passage and suction experiments were performed with dry trip wires and repeated after soaking with bloody, mucous fluids.
With all bands present, endoscopic views were 90 and 40% in the new and current MBM-device, respectively. With the release of more bands, differences slowly disappeared. The panel scored a better endoscopic view in the new MBM-device (p = 0.03). Passage of all accessories was considered significantly easier in the new MBM-device. With the associated snare in the working channel, suction power was significantly better with the new MBM-device.
Compared to the currently available MBM-device, the new MBM-device provides improved endoscopic visibility, smoother passage of accessories, and higher suction power.
多波段黏膜切除术（MBM）广泛用于上消化道早期肿瘤的内镜切除。一种新型MBM设备可能优于当前的MBM设备，因其不同的绊线和帽，具有更好的可视化效果、更易于附件通过以及更高的吸力。
在收集内镜图像时，两种MBM设备逐个释放橡皮筋。首先，通过计算机辅助测量（定量）以及由11名内镜医师组成的小组对图像进行排名（定性）来评估自由内镜视野。其次，使用视觉模拟量表，三名“盲法”内镜医师在组装有MBM设备的诊断性内镜工作通道中评估三种类型内镜设备的插入和推进情况。第三，通过连接到组装好的MBM设备帽上的压力计在四台内镜中评估吸力。在抽吸5秒和10秒后测量负压，并重复五次。通道和抽吸实验在干燥的绊线情况下进行，并在被血性、黏液性液体浸泡后重复。
所有橡皮筋都存在时，新型和当前MBM设备的内镜视野分别为90%和40%。随着更多橡皮筋的释放，差异逐渐消失。小组对新型MBM设备的内镜视野评分更高（p = 0.03）。新型MBM设备中所有附件的通过被认为明显更容易。当工作通道中有相关圈套器时，新型MBM设备的吸力明显更好。
与目前可用的MBM设备相比，新型MBM设备提供了更好的内镜可视性、更顺畅的附件通过以及更高的吸力。
