Stiegmann G V, Sun J H, Hammond W S
University of Colorado Health Sciences Center, Department of Surgery, Denver 80262.
Am Surg. 1988 Feb;54(2):105-8.
Endoscopic Variceal ligation (EVL) is performed using a flexible gastroscope and a recently developed elastic band ligating device. Varices from 3-5 mm in diameter were created in a canine model. Thirty seven variceal sites underwent EVL with successful ligation on first attempt in 34 (92%). Gross and microscopic examination of treated sites at 1-60 days showed ischemic necrosis of mucosa and submucosa (24 hours), acute inflammation, demarcation of viable and necrotic tissue, and appearance of granulation tissue (3-7 days), full thickness replacement of mucosa and submucosa with maturing scar tissue and near complete re-epithelialization (14-21 days), and complete healing (50-60 days). Inflammation and scar tissue deposition consistently obliterated submucosal venous channels but left muscularis propria intact. No perforations or other adverse clinical or histological effects were observed. EVL treatment of canine esophageal varices appears to result in safe and effective obliteration of vascular channels in the submucosa by a process of inflammation and scar formation.
内镜下静脉曲张结扎术（EVL）使用柔性胃镜和最近开发的弹性带结扎装置进行。在犬模型中创建直径为3 - 5毫米的静脉曲张。37个静脉曲张部位接受了EVL，首次尝试成功结扎34个（92%）。在1 - 60天对治疗部位进行大体和显微镜检查显示，黏膜和黏膜下层出现缺血性坏死（24小时）、急性炎症、存活组织与坏死组织分界、肉芽组织形成（3 - 7天）、黏膜和黏膜下层被成熟瘢痕组织完全替代且近乎完全重新上皮化（14 - 21天）以及完全愈合（50 - 60天）。炎症和瘢痕组织沉积持续闭塞黏膜下静脉通道，但肌层保持完整。未观察到穿孔或其他不良临床或组织学效应。犬食管静脉曲张的EVL治疗似乎通过炎症和瘢痕形成过程安全有效地闭塞了黏膜下血管通道。
