Chen Shengsen, Zhou Danping, Ruan Rongwei, Yu Jiangping, Li Yandong, Liu Yuanshun, Wang Shi
Department of Endoscopy, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang, China.
Front Med (Lausanne). 2021 Jan 20;7:619844. doi: 10.3389/fmed.2020.619844. eCollection 2020.
Endoscopic resection (ER) is more difficult and has a higher rate of complications, such as perforation and bleeding. The aim of this study was to evaluate the safety and feasibility of a bipolar polypectomy snare for ER. Initial ER procedures in live pigs were carried out. Then, a human feasibility study was performed in patients with colorectal polyps. Finally, the finite element method was used to evaluate the safety and effectiveness of the new bipolar snare. In the live animal model, there were no significant differences in wound size and cutting time between monopolar and bipolar groups. The histological results (histological scores) of the two groups in porcine experiments were almost the same except that the incision flatness of bipolar group was better than that of the monopolar group. Incidence of bleeding and perforation was similar between the two groups in pigs' and patients' study. At last, the finite element model showed that the vertical thermal damage depth produced by bipolar snare system was approximately 71-76% of that produced by monopolar snare system at the same power. The novel bipolar snare is feasible in patients with colorectal polyps and can be an alternative choice for ERs.
内镜切除术(ER)难度更大,并发症发生率更高,如穿孔和出血。本研究的目的是评估用于ER的双极息肉切除圈套器的安全性和可行性。首先对活猪进行了初步的ER手术。然后,对结直肠息肉患者进行了人体可行性研究。最后,使用有限元方法评估新型双极圈套器的安全性和有效性。在活体动物模型中,单极组和双极组在伤口大小和切割时间上没有显著差异。除双极组的切口平整度优于单极组外,两组在猪实验中的组织学结果(组织学评分)几乎相同。在猪和患者的研究中,两组的出血和穿孔发生率相似。最后,有限元模型显示,在相同功率下,双极圈套器系统产生的垂直热损伤深度约为单极圈套器系统的71%-76%。新型双极圈套器在结直肠息肉患者中是可行的,可作为ER的替代选择。