Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Collaborative Innovation Center of Endoscopy, Shanghai, China.
Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Collaborative Innovation Center of Endoscopy, Shanghai, China.
Gastrointest Endosc Clin N Am. 2023 Jan;33(1):143-154. doi: 10.1016/j.giec.2022.07.002.
The concept of third space endoscopy is based on the principle that the deeper layers of the gastrointestinal tract can be accessed by tunneling in the submucosal space and maintaining the integrity of the overlying mucosa. The mucosal flap safety valve enabled endoscopists to use submucosal space securely. The era of third space endoscopy started with peroral endoscopic myotomy for treatment of achalasia and has expanded to treat various other gastrointestinal disorders, such as mucosal lesions, submucosal tumors, extraluminal tumors, and refractory gastroparesis, Zenker diverticulum, and restoration of the completely obstructed esophageal lumen. Third space endoscopy rapidly emerged as a minimally invasive alternative to conventional surgery. Many studies discovered that this technique is safe and effective with excellent outcomes. Our review focused on the indications, techniques, clinical management, and adverse events of submucosal tunneling techniques for tumor resection.
第三空间内镜的概念基于这样一个原理，即通过在黏膜下空间进行隧道掘进，并保持覆盖黏膜的完整性，可以进入胃肠道的更深层。黏膜瓣安全瓣使内镜医生能够安全地使用黏膜下空间。第三空间内镜的时代始于经口内镜肌切开术治疗贲门失弛缓症，并已扩展到治疗各种其他胃肠道疾病，如黏膜病变、黏膜下肿瘤、腔外肿瘤和难治性胃轻瘫、Zenker 憩室以及完全阻塞食管腔的重建。第三空间内镜迅速成为传统手术的一种微创替代方法。许多研究发现，该技术具有良好的效果，且安全有效。我们的综述重点关注黏膜下隧道技术用于肿瘤切除的适应证、技术、临床管理和不良事件。
