Senior Department of Gastroenterology, The First Medical Center of Chinese, PLA General Hospital, Beijing, 100853, China.
Department of Gastroenterology, The Seventh Medical Center of Chinese, PLA General Hospital, No. 5 Nan Men Cang, Dong Cheng District, Beijing, 100700, China.
Sci Rep. 2024 May 2;14(1):10060. doi: 10.1038/s41598-024-61031-4.
This study aimed to evaluate the safety and efficiency of hybrid endoscopic submucosal dissection (H-ESD) using a newly developed ALL IN ONE (AIO) snare. This was a matched control study in a porcine model. Five paired simulated stomach lesions 2-2.5 cm in size were removed by H-ESD using an AIO snare or conventional ESD (C-ESD) using an endoscopic knife. The outcomes of the two procedures were compared, including en-bloc resection rates, procedure times, intraprocedural bleeding volumes, muscular injuries, perforations, thicknesses of the submucosal layer in resected specimens, and stomach defects. All simulated lesions were resected en-bloc. Specimens resected by H-ESD and C-ESD were similar in size (7.68 ± 2.92 vs. 8.42 ± 2.42 cm; P = 0.676). H-ESD required a significantly shorter procedure time (13.39 ± 3.78 vs. 25.99 ± 4.52 min; P = 0.031) and submucosal dissection time (3.99 ± 1.73 vs. 13.1 ± 4.58 min; P = 0.003) versus C-ESD; H-ESD also yielded a faster dissection speed (241.37 ± 156.84 vs. 68.56 ± 28.53 mm/min; P = 0.042) and caused fewer intraprocedural bleeding events (0.40 ± 0.55 vs. 3.40 ± 1.95 times/per lesion; P = 0.016) than C-ESD. The thicknesses of the submucosal layer of the resected specimen (1190.98 ± 134.07 vs. 1055.90 ± 151.76 μm; P = 0.174) and the residual submucosal layer of the stomach defect (1607.94 ± 1026.74 vs. 985.98 ± 445.58 μm; P = 0.249) were similar with both procedures. The AIO snare is a safe and effective device for H-ESD and improves the treatment outcomes of gastric lesions by shortening the procedure time.
本研究旨在评估使用新型 ALL IN ONE（AIO）圈套器进行混合内镜黏膜下剥离术（H-ESD）的安全性和有效性。这是一项在猪模型中进行的配对对照研究。使用 AIO 圈套器或传统内镜刀对 5 对大小为 2-2.5cm 的模拟胃病变进行 H-ESD 切除。比较两种方法的手术结果，包括整块切除率、手术时间、术中出血量、肌肉损伤、穿孔、切除标本黏膜下层厚度和胃缺损。所有模拟病变均整块切除。H-ESD 和 C-ESD 切除的标本大小相似（7.68±2.92cm 比 8.42±2.42cm；P=0.676）。H-ESD 手术时间明显缩短（13.39±3.78min 比 25.99±4.52min；P=0.031）和黏膜下剥离时间（3.99±1.73min 比 13.1±4.58min；P=0.003）比 C-ESD 短；H-ESD 还具有更快的剥离速度（241.37±156.84mm/min 比 68.56±28.53mm/min；P=0.042），术中出血事件更少（0.40±0.55 次/病变比 3.40±1.95 次/病变；P=0.016）。切除标本黏膜下层厚度（1190.98±134.07μm 比 1055.90±151.76μm；P=0.174）和胃缺损残留黏膜下层厚度（1607.94±1026.74μm 比 985.98±445.58μm；P=0.249）在两种方法中相似。AIO 圈套器是一种安全有效的 H-ESD 治疗工具，可通过缩短手术时间来改善胃病变的治疗效果。
