Lin Wen, He Xiao-Jian, Hong Dong-Gui, Chen Long-Ping, Zhuang Yan, Liu Mei-Yan, Lin Han, Jiang Chuan-Shen, Li Da-Zhou, Wang Wen
Department of Gastroenterology, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, 350025, China.
Department of Gastroenterology, 900th Hospital of PLA Joint Logistic Support Force, 156 North Road of West No.2 Ring, Fuzhou, 350025, China.
BMC Gastroenterol. 2025 Aug 18;25(1):589. doi: 10.1186/s12876-025-04166-6.
Adhesive intestinal obstruction is a common clinical condition caused by obstruction of the intestinal contents. Adhesiolysis is an effective treatment, but traditional open or laparoscopic adhesiolysis is traumatic and often causes a recurrence of adhesions. In this study, we investigate the feasibility and safety of adhesiolysis via transumbilical endoscopic surgery (TUES) with a gastric endoscopy.
Eight beagles were used to establish a model of adhesive intestinal obstruction through open simulated surgery. TUES adhesiolysis with a gastric endoscopy was performed 2 weeks later. The time of adhesiolysis, vital signs of beagles, intraoperative hemorrhage, intraoperative and postoperative complications were recorded and analyzed. Three months later, the abdominal cavity was re-explored to observe whether there were recurrences of adhesions, abdominal infections, and other complications.
The modeling of all 8 beagles was successfully achieved in the formation of adhesive intestinal obstruction, and the TUES adhesiolysis was successfully completed. The median (interquartile range) time of adhesiolysis was 83(9) minutes. The vital signs of the beagles were stable, and there were no adverse events, including heavy bleeding, perforation, or mortality during the operation. All 8 beagles survived without postoperative complications such as delayed bleeding, peritonitis, intra-abdominal abscess, and abdominal wall incisional hernia three months after adhesiolysis.
TUES adhesiolysis has been preliminarily proven to be minimally invasive, safe, and effective, which provides a new option for adhesive intestinal obstruction.
粘连性肠梗阻是一种由肠内容物梗阻引起的常见临床病症。粘连松解术是一种有效的治疗方法,但传统的开放或腹腔镜粘连松解术具有创伤性,且常导致粘连复发。在本研究中,我们探讨经脐单孔腹腔镜手术(TUES)联合胃镜进行粘连松解术的可行性和安全性。
选用8只比格犬,通过开放模拟手术建立粘连性肠梗阻模型。2周后行TUES联合胃镜粘连松解术。记录并分析粘连松解时间、比格犬生命体征、术中出血情况、术中及术后并发症。3个月后再次剖腹探查,观察有无粘连复发、腹腔感染及其他并发症。
8只比格犬均成功建立粘连性肠梗阻模型,且TUES粘连松解术均顺利完成。粘连松解时间中位数(四分位间距)为83(9)分钟。比格犬生命体征平稳,术中无大出血、穿孔、死亡等不良事件发生。粘连松解术后3个月,8只比格犬均存活,无迟发性出血、腹膜炎、腹腔脓肿、腹壁切口疝等术后并发症。
TUES粘连松解术初步证明具有微创、安全、有效的特点,为粘连性肠梗阻提供了一种新的治疗选择。