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首页> 外文期刊>Endoscopy International Open >Endoscopic mucosal resection with an additional working channel (EMR+) in a porcine ex vivo model: a novel technique to improve en bloc resection rate of snare polypectomy
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Endoscopic mucosal resection with an additional working channel (EMR+) in a porcine ex vivo model: a novel technique to improve en bloc resection rate of snare polypectomy

机译：内镜粘膜切除在猪前体内模型中具有额外的工作通道（EMR +）：一种提高SNARE POLPECTOMY en Cloc切除率的新技术

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Background and study aims?Recently, a new external additional working channel (AWC) was introduced by which conventional endoscopic mucosal resection (EMR) can be improved to a technique termed “EMR+”. We first evaluated this novel technique in comparison to classical EMR in flat lesions. Methods?The trial was prospectively conducted in an ex vivo animal model with porcine stomachs placed into the EASIE-R simulator. Prior to intervention, standardized lesions were set by coagulation dots, measuring 1, 2, 3 or 4?cm. Results?Overall, 152 procedures were performed. EMR and EMR+ were both very reliable in 1-cm lesions, each showing en bloc resection rates of 100?%. EMR+ en bloc resection rate was significantly higher in 2-cm lesions (95.44?% vs. 54.55?%, P?=?0.02), in 3-cm lesions (86.36?% vs. 18.18?%, P??0.01) and also in 4-cm lesions (60.00?% vs. 0?%, P??0.01). Perforations occurred only in EMR+ procedures in 4-cm lesions (3 of 20; 15?%). Conclusions?With its grasp-and-snare technique, EMR+ facilitates en bloc resection of larger lesions compared to conventional EMR. In lesions 2?cm and larger, EMR+ has demonstrated advantages, especially concerning en bloc resection rate. At 3?cm, EMR+ reaches its best discriminatory power whereas EMR+ has inherent limits at 4?cm and in lesions of that size, other techniques such as ESD or surgery should be considered. sup*/sup These authors contributed equally.
机译：背景和研究目标？最近，引入了一种新的外部额外工作通道（AWC），通过该常规内窥镜粘膜切除（EMR）可以改善为称为“EMR +”的技术。我们首先评估了与典型EMR在扁平病变中的典型EMR相比。方法？试验在前体内动物模型中进行，猪胃放入EASIE-R模拟器中。在干预之前，通过凝固点设置标准化的病变，测量1,2,3或4Ωcm。结果？总体而言，进行了152个程序。 EMR和EMR +在1厘米的病变中均非常可靠，每次显示en Bloc切除率为100？％。 EMR + EN Bloc切除率在2cm病灶中显着较高（95.44倍，54.55μm，p？= 0.02），在3厘米的病变中（86.36〜0 vs.18.18？％，p？<？0.01 ）并且还在4厘米的病变中（60.00？％与0≤％，p？<0.01）。穿孔仅在4厘米病变中的EMR +程序中发生（20个; 15？％）。结论？随着其掌握和圈套技术，EMR +与传统EMR相比，EMR +促进了较大病变的较大的病变。在病变2？CM和更大的情况下，EMR +已经证明了优势，特别是关于EN集团切除率。在3厘米，EMR +达到其最佳歧视性，而EMR +具有4℃的固有限制，并且在该尺寸的病变中，应考虑其他技术，例如ESD或手术。 * 这些作者平均贡献。

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