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首页> 外文期刊>Endoscopy International Open >Waterjet submucosal dissection of porcine esophagus with the HybridKnife and ERBEJET 2 system: a pilot study
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Waterjet submucosal dissection of porcine esophagus with the HybridKnife and ERBEJET 2 system: a pilot study

机译：HybridKnife和ERBEJET 2系统对猪食管进行水刀黏膜剥离术的初步研究

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Background and study aims?Esophageal endoscopic submucosal dissection (ESD) is technically difficult because of narrow working spaces and ease of perforation due to the lack of serosa. HybridKnife is a recently developed ESD device that is combined with the high pressure waterjet ERBEJET 2 system to lift mucosa. We hypothesized that this waterjet could make submucosal dissection safer and studied this in porcine esophagus. Materials and methods?Water pressures of 30?–?70?bar were tested to determine the appropriate pressure for waterjet ESD with HybridKnife (WJ-ESD) in one pig. WJ-ESD safety and completion were compared with those of conventional ESD using DualKnife (C-ESD) as a reference. Each of three virtual esophageal lesions in two pigs were resected alternatively using both methods from the lower to upper esophagus. For WJ-ESD, the submucosa, apart from hard fibrous tissues, was dissected using water pressure alone. Results?Using 50?bar of water pressure resulted in the best balance between proper dissection and view-disturbing water backflow. The dissection speeds for the lower, middle, and upper esophagus were 0.2, 0.9, and 0.2?cm2/min in 50?bar WJ-ESD and 1.1, 0.5, and 1.0?cm2/min in C-ESD, respectively. Minor bleeding was frequent in WJ-ESD, but was easily stopped by electrocoagulation with the same needle. No perforation was observed in either procedure. Thermal damage to dissected tissues appeared mild, and the extent of muscle injury was lower for WJ-ESD (4, 6, and 8?%) compared with C-ESD (14, 16, and 7?%). Conclusions?WJ-ESD could be completed safely for porcine esophagus with less damage to the muscle layer compared with C-ESD.
机译：背景和研究目的：食管内镜黏膜下剥离术（ESD）由于狭窄的工作空间和缺乏浆膜的穿孔而在技术上很困难。 HybridKnife是最近开发的ESD设备，与高压水刀ERBEJET 2系统结合起来可提起粘膜。我们假设这种水刀可以使粘膜下剥离更安全，并在猪食管中进行了研究。材料和方法测试了30？-？70？bar的水压，以确定一只猪用HybridKnife（WJ-ESD）进行水刀ESD的合适压力。使用双刀（C-ESD）作为参考，将WJ-ESD的安全性和完成度与传统ESD的安全性和完成度进行了比较。从下到上食管交替使用两种方法切除两头猪的三个虚拟食管病变。对于WJ-ESD，仅使用水压将粘膜下层和硬纤维组织分开。结果：使用50 bar的水压可在适当解剖与干扰视线的水回流之间达到最佳平衡。在50？bar WJ-ESD中，下，中和上食管的解剖速度分别为0.2、0.9和0.2？cm2 / min，在C-ESD中，分别为1.1、0.5和1.0？cm2 / min。 WJ-ESD经常发生轻微出血，但用同一根针进行电凝可轻松停止。两种方法均未观察到穿孔。与C-ESD（14％，16％和7％）相比，WJ-ESD（4％，6％和8％）对解剖组织的热损伤显得轻微，并且肌肉损伤的程度更低。结论与C-ESD相比，WJ-ESD可以安全完成猪食管，对肌肉层的损害较小。

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