Patil Gaurav, Dalal Anki, Maydeo Amit P
Baldota Institute of Digestive Sciences, Gleneagles Global Hospitals, Mumbai, Maharashtra, India.
Endosc Int Open. 2020 Aug;8(8):E998-E1001. doi: 10.1055/a-1165-0087. Epub 2020 Jul 21.
During peroral endoscopic myotomy (POEM), use of traditional instruments leads to an increase in overall time of procedure due to constant exchange of instruments. Speedboat-RS2 (Creo-Medical, UK) is a novel device which has shown promising results for endoscopic submucosal dissection of gastrointestinal lesions, but its feasibility, and safety for POEM is unexplored. Data from patients who had undergone POEM for achalasia cardia utilizing Speedboat-RS2 was reviewed. Two patients with mean age of 46 years and mean symptom duration of 3 years were included. Both patients had type II achalasia diagnosed on esophageal manometry. One patient underwent anterior myotomy and the other posterior approach. Submucosal tunneling (15 cm) was achieved in a mean of 20 minutes, myotomy ( 9 cm) in 8 minutes and the entire procedure was completed in a mean of 30 minutes with 100 % technical success. Both patients were discharged the day after the procedure without any immediate adverse events. At 6 weeks, endoscopy was uneventful and the patients were asymptomatic. Early experience shows that Speedboat-RS2 is feasible for performing POEM with good safety profile. Submucosal tunneling was relatively quick and coagulation was effective. Long term studies with a larger patient cohort are warranted.
在经口内镜下肌切开术（POEM）过程中，由于需要不断更换器械，使用传统器械会导致手术总时间增加。Speedboat-RS2（英国Creo-Medical公司）是一种新型设备，已在胃肠道病变的内镜黏膜下剥离术中显示出良好效果，但其在POEM中的可行性和安全性尚未得到探索。我们回顾了使用Speedboat-RS2进行贲门失弛缓症POEM手术患者的数据。纳入了两名平均年龄46岁、平均症状持续时间3年的患者。两名患者经食管测压均诊断为Ⅱ型失弛缓症。一名患者采用前肌切开术，另一名采用后入路。平均20分钟完成黏膜下隧道（约15厘米）建立，8分钟完成肌切开术（约9厘米），整个手术平均30分钟完成，技术成功率达100%。两名患者均在术后次日出院，无任何即刻不良事件。术后6周，内镜检查无异常，患者无症状。早期经验表明，Speedboat-RS2用于POEM手术是可行的，安全性良好。黏膜下隧道建立相对较快，凝血效果良好。有必要对更大患者队列进行长期研究。
