Jung Yunho, Baik Gwang Ho, Ko Weon Jin, Ko Bong Min, Kim Seong Hwan, Jang Jin Seok, Jang Jae-Young, Lee Wan-Sik, Cho Young Kwan, Lim Sun Gyo, Moon Hee Seok, Yoo In Kyung, Cho Joo Young
Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.
Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.
Clin Endosc. 2021 Jul;54(4):555-562. doi: 10.5946/ce.2020.229. Epub 2021 Jan 13.
BACKGROUND/AIMS: A new medical fiber-guided diode laser system (FDLS) is expected to offer high-precision cutting with simultaneous hemostasis. Thus, this study aimed to evaluate the feasibility of using the 1,940-nm FDLS to perform endoscopic submucosal dissection (ESD) in the gastrointestinal tract of an animal model.
In this prospective animal pilot study, gastric and colorectal ESD using the FDLS was performed in ex vivo and in vivo porcine models. The completeness of en bloc resection, the procedure time, intraprocedural bleeding, histological injuries to the muscularis propria (MP) layer, and perforation were assessed.
The en bloc resection and perforation rates in the ex vivo study were 100% (10/10) and 10% (1/10), respectively; those in the in vivo study were 100% (4/4) and 0% for gastric ESD and 100% (4/4) and 25% (1/4) for rectal ESD, respectively. Deep MP layer injuries tended to occur more frequently in the rectal than in the gastric ESD cases, and no intraprocedural bleeding occurred in either group.
The 1,940-nm FDLS was capable of yielding high en bloc resection rates without intraprocedural bleeding during gastric and colorectal ESD in animal models.
背景/目的：一种新型的医用光纤引导二极管激光系统（FDLS）有望实现高精度切割并同时止血。因此，本研究旨在评估使用1940纳米FDLS在动物模型胃肠道中进行内镜黏膜下剥离术（ESD）的可行性。
在这项前瞻性动物初步研究中，使用FDLS在离体和活体猪模型中进行胃和结肠ESD。评估整块切除的完整性、手术时间、术中出血、固有肌层（MP）的组织学损伤和穿孔情况。
离体研究中的整块切除率和穿孔率分别为100%（10/10）和10%（1/10）；活体研究中，胃ESD的整块切除率和穿孔率分别为100%（4/4）和0%，直肠ESD的整块切除率和穿孔率分别为100%（4/4）和25%（1/4）。直肠ESD病例中，MP深层损伤的发生率往往高于胃ESD病例，两组均未发生术中出血。
在动物模型中，1940纳米FDLS在胃和结肠ESD过程中能够实现高整块切除率且无术中出血。
