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首页> 外文期刊>Endoscopy International Open >An innovative ex-vivo porcine upper gastrointestinal model for submucosal tunnelling endoscopic resection (STER)
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An innovative ex-vivo porcine upper gastrointestinal model for submucosal tunnelling endoscopic resection (STER)

机译：黏膜下隧道内镜切除术（STER）的创新的离体猪上消化道模型

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Background and study aims: Submucosal tunnelling endoscopic resection (STER) is a novel endoscopic technique to remove submucosal tumour (SMT). We propose a novel, low cost simulator for training of techniques for STER. Patients and methods: The model consisted of an ex-planted porcine oesophagus, stomach and duodenum with marbles embedded surgically in the submucosal plane. Two expert endoscopists with experience in submucosal tunnelling and 5 board-certified endoscopists with no experience in submucosal tunnelling were recruited. Participants were asked to perform a diagnostic endoscopy and 2 STER procedures, 1 in the oesophagus and 1 in the stomach. They also answered a structured questionnaire. Factors including operative time, mucosal and muscular injury rate, injection volume and accuracy of endoscopic closure were assessed. Results: The median time for localization of all SMTs was 40.1 seconds for experts and 38.5 seconds for novices (P?=?1.000). For esophageal STER, the length of mucosal incisions and tunnelling distances were comparable between the 2 groups. The median volume injected by the novice group was significantly lower than the experts (15?mL vs 42.5?mL (P?=?0.05). The median tunnelling time per length was 25.9 seconds/mm for the experts and 40.8 seconds/mm for the novice group (P?=?0.38). There was a higher rate of mucosal injury and muscular perforation in the novice group (8 vs 0; P?=?0.05). For gastric STER, the length of mucosal incisions and tunnel distances were comparable between the 2 groups. The median tunnelling time per length for the experts was 23.3 seconds/mm and 34.6 seconds/mm for the novice group (P?=?0.38). One mucosal injury was incurred by a novice. The rate of dissection in the stomach and the oesophagus was not statistically different (P?=?0.620). All participants voted that the model provides a realistic simulation and recommended it for training. Conclusions: STER is an advanced endoscopic technique where its indication is currently explored. Experienced and novice STER endoscopists have expressed the usefulness of this model as a training tool. This low-cost model can be used for future research in STER.
机译：背景与研究目的：黏膜下隧道内镜切除术（STER）是一种去除黏膜下肿瘤（SMT）的新型内镜技术。我们提出了一种新颖的低成本模拟器，用于STER技术的培训。患者和方法：该模型由外植的猪食道，胃和十二指肠组成，并在外科手术中将黏膜埋在粘膜下层。招募了两名具有粘膜下穿隧经验的专家内窥镜专家和五名没有粘膜下穿隧经验的内阁认证内镜专家。要求参与者进行诊断性内窥镜检查和2项STER手术，其中1例在食道，1例在胃。他们还回答了结构化问卷。评估手术时间，粘膜和肌肉损伤率，注射量和内镜关闭的准确性等因素。结果：专家对所有SMT定位的中值时间为40.1秒，新手为38.5秒（P = 1.000）。对于食管STER，两组之间的粘膜切口长度和穿隧距离相当。新手组注射的中位体积显着低于专家（分别为15？mL和42.5？mL（P？=？0.05）;专家的每长度中位隧穿时间分别为25.9秒/ mm和40.8秒/ mm新手组（P？=？0.38）。新手组黏膜损伤和肌肉穿孔的发生率更高（8 vs 0; P？=？0.05）。对于胃STER，粘膜切口的长度和隧道距离两组之间具有可比性，专家的每长度平均穿隧时间为23.3秒/ mm，新手组为34.6秒/mm（P?=?0.38），新手发生了1次粘膜损伤。结论：STER是一种先进的内窥镜技术，目前正在研究其适应症，其在胃和食道的解剖学上没有统计学差异（P = 0.620），所有参与者都投票认为该模型提供了一种现实的模拟，并建议将其用于训练。经验丰富的STER内镜医师和新手都表示有用该模型是否可作为培训工具。这种低成本模型可用于STER的未来研究。

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