Shiratori Yasutoshi, Ikeya Takashi, Suzuki Koyu, Yamamoto Kazuki, Yoshimoto Takaaki, Takasu Ayaka, Oguri Noriaki, Okamoto Takeshi, Okuyama Syuhei, Takagi Koichi, Fukuda Katsuyuki
Division of Gastroenterology St. Luke's International Hospital Tokyo Japan.
Department of Pathology St. Luke's International Hospital Tokyo Japan.
JGH Open. 2020 Oct 28;5(1):50-55. doi: 10.1002/jgh3.12445. eCollection 2021 Jan.
Endoscopic band ligation (EBL), used for the treatment of colonic diverticular bleeding, has a lower rebleeding rate than endoscopic clipping. However, different devices are used in Japan and the Western countries; no animal studies have been conducted to elucidate the safety of such devices. We compared two EBL devices, the first used in Japan and the second used in Western countries.
The Japanese and Western EBL devices were compared by assessing the EBL safety at 40 sites in an animal model with a normal colon that is anatomically similar to the human colon. Macroscopic and pathological examinations were performed to evaluate the layer ligated by the band and the presence of perforation. The findings on day 1 and day 7 after EBL were compared. The ligated layer was the muscularis propria at 39 sites; the layer was not evaluated at one site where the band was unintentionally removed during the endoscopic procedure. Pathologically, there was no perforation at any of the assessed sites. There was no statistical difference in any of the pathological variables between the two devices or between days 1 and 7 after EBL. The total procedure time was significantly shorter with the Western EBL device.
In this animal study, both evaluated devices were safe for EBL, without differences in the macroscopic and pathological variables after EBL. Ligation of the muscularis propria layer did not result in perforation.
内镜下套扎术（EBL）用于治疗结肠憩室出血，其再出血率低于内镜下钳夹术。然而，日本和西方国家使用的设备不同；尚未进行动物研究以阐明此类设备的安全性。我们比较了两种EBL设备，一种在日本使用，另一种在西方国家使用。
通过在解剖结构与人类结肠相似的正常结肠动物模型中的40个部位评估EBL安全性，比较了日本和西方的EBL设备。进行了宏观和病理学检查，以评估套扎带结扎的层次和穿孔情况。比较了EBL后第1天和第7天的结果。在39个部位，结扎的层次为固有肌层；在内镜操作过程中，有一个部位的套扎带意外脱落，该部位未评估结扎层次。病理检查显示，所有评估部位均无穿孔。两种设备之间以及EBL后第1天和第7天之间的任何病理变量均无统计学差异。使用西方EBL设备时，总操作时间明显更短。
在本动物研究中，两种评估的设备用于EBL均安全，EBL后宏观和病理变量无差异。固有肌层的结扎未导致穿孔。
