Kozuka Kazuhiro, Kobara Hideki, Nishiyama Noriko, Fujihara Shintaro, Tada Naoya, Matsui Takanori, Takata Tadayuki, Chiyo Taiga, Kobayashi Nobuya, Shi Tingting, Fujita Koji, Tani Joji, Yachida Tatsuo, Kondo Akihiro, Kumamoto Kensuke, Okano Keiichi, Nishiyama Akira, Deguchi Kazushi, Masaki Tsutomu
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa 761-0793, Japan.
Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Kagawa 761-0793, Japan.
J Clin Med. 2021 Aug 25;10(17):3796. doi: 10.3390/jcm10173796.
Pooled gastric residues involving blood clots and food interrupt appropriate endoscopic intervention, leading to poor outcomes in endoscopic hemostasis and lifesaving. However, procedures and devices that enable the effective removal of gastrointestinal residues remain unsatisfactory. This study aimed to evaluate the efficacy and safety of our developed suction method in ex vivo and in vivo studies. We created a hand-made device with a large suction diameter, consisting of a balloon overtube and an ultrathin endoscope for navigation. In the ex vivo study, we compared the success rate and the suctioning time for four types of simulated residue between a standard endoscope and our device. Our device had s significantly higher suction ability and a shorter procedure time than the standard endoscope. The subsequent in vivo animal study involved five beagle dogs that were administered with food jelly to mimic gastric residue. Suction was performed twice for five dogs (ten attempts). The outcome measure was the successful procedure rate; secondary outcomes were procedure-associated complications and procedure time. The procedure was successful in all attempts, without any complications. The mean procedure time was 5 min. This novel method enabled the efficient and safe removal of gastric residue, and our findings will likely lead to the development of the instrument.
含有血凝块和食物的胃内残留物积聚妨碍了适当的内镜干预，导致内镜止血和挽救生命的效果不佳。然而，能够有效清除胃肠道残留物的程序和设备仍不尽人意。本研究旨在评估我们开发的抽吸方法在体外和体内研究中的有效性和安全性。我们制作了一种具有大抽吸直径的手工装置，它由一个球囊外套管和一根用于导航的超细内窥镜组成。在体外研究中，我们比较了标准内窥镜和我们的装置对四种模拟残留物的成功率和抽吸时间。我们的装置比标准内窥镜具有显著更高的抽吸能力和更短的操作时间。随后的体内动物研究涉及五只比格犬，给它们喂食果冻以模拟胃内残留物。对五只狗进行了两次抽吸（十次尝试）。观察指标是手术成功率；次要指标是与手术相关的并发症和手术时间。所有尝试均成功完成，没有任何并发症。平均手术时间为5分钟。这种新方法能够高效、安全地清除胃内残留物，我们的研究结果可能会推动该器械的开发。
