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首页> 外文期刊>Surgical Endoscopy >An internal magnet traction device reduces procedure time for endoscopic submucosal dissection by expert and non-expert endoscopists: ex vivo study in a porcine colorectal model (with video)
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An internal magnet traction device reduces procedure time for endoscopic submucosal dissection by expert and non-expert endoscopists: ex vivo study in a porcine colorectal model (with video)

机译：内部磁铁牵引装置降低了专家和非专家内窥镜师的内窥镜粘膜粘膜分析的程序时间：猪结直肠模型中的前体内研究（带视频）

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摘要

BackgroundEfficacy of an internal magnet traction device (MTD) for gastric endoscopic submucosal dissection (ESD) by an expert endoscopist has been reported. We hypothesized that use of the MTD would enhance the performance of colorectal ESD in a non-expert endoscopist in ESD compared to the conventional technique. Primary aim of this study was to compare procedure times between conventional ESD (C-ESD) and MTD-assisted ESD (MTD-ESD) by expert and non-expert endoscopists in ESD. Secondary aims included rate of en bloc resection, iatrogenic injury, visualization score of the submucosal layer, and endoscopist satisfaction score.MethodsA total of 56 lesions were created in an ex vivo porcine colorectum. Two endoscopists completed C-ESD (n=28) and MTD-ESD (n=28). Lesions measured 3cm in diameter and were located on either the anterior or posterior colorectal wall. The MTD consisted of a small neodymium magnet and nylon monofilament attached to a through-the-scope clip. The first MTD was deployed on the opposing colorectal wall of the target lesion and a second MTD was then deployed directly onto the distal margin of the lesion.ResultsTotal procedure time for MTD-ESD was significantly shorter than C-ESD for both expert (median: 15.8 vs. 19.3min, p<0.05) and non-expert (median: 21.3 vs. 33.9min, p<0.001) endoscopists. All lesions were resected en bloc. There was no iatrogenic muscularis propria injury in the MTD-ESD group. For both the expert and non-expert, scores for MTD-ESD were significantly higher for submucosal layer visualization (p<0.05) and endoscopist satisfaction (p<0.001) compared to C-ESD.ConclusionsUse of the MTD significantly reduced procedure time for both expert and non-expert endoscopists performing ESD. Improving the efficiency, safety, and satisfaction of ESD with such a device particularly for non-expert endoscopists is appealing and could potentially minimize the complexity and duration of the procedure allowing for more widespread use of the technique.
机译：内部磁铁牵引装置的BackgroundEfficacy（MTD）用于胃内窥镜黏膜下层剥离术（ESD）由专家内窥镜医生已经报道。我们假设，使用MTD将加强结防静电的ESD中的非专业内镜的性能相比传统技术。本研究的主要目的是通过在ESD专家和非专家内镜比较传统的ESD（C-ESD）和MTD辅助ESD（MTD-ESD）之间的手术时间。次要目标包括整块切除，医源性损伤，粘膜下层的可视化分数，并且内窥镜医师满意score.MethodsA总共56个病灶的速率在体外猪结肠直肠创建。两个内镜完成C-ESD（N = 28）和MTD-ESD（N = 28）。病变的直径测量3厘米和分别位于任一前部或后部结肠壁。在MTD包括附连到直通范围剪辑小钕磁铁和尼龙单丝的。第一MTD被部署在目标病灶的相对结壁，然后将第二MTD直接部署到的lesion.ResultsTotal过程时间MTD-ESD比C-ESD显著较短两个专家（中位数远端余量： 15.8与19.3min，p <0.05）和非专家（中值：21.3对比33.9min，p <0.001）内镜。所有病灶切除整块。有是MTD-ESD组无医源性固有肌层损伤。对于专家和非专家两者分数MTD-ESD分别为相比于MTD的C-ESD.ConclusionsUse显著减少过程时间两者粘膜下层的可视化（P <0.05）和内窥镜医师满意度（P <0.001）更高显著专家和非专家内镜进行ESD。提高了工作效率，安全性和满意度ESD与这种设备特别是对于非专业的内镜是有吸引力和有可能尽量减少允许更广泛地使用该技术的过程的复杂性和持续时间。

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  • 来源
    《Surgical Endoscopy》 |2019年第8期|共8页
  • 作者

    Dobashi Akira; Storm Andrew C.; Song Louis M. Wong Kee; Deters Jodie L.; Miller Charles A.; Tholen Crystal J.; Gostout Christopher J.; Rajan Elizabeth;

  • 作者单位

    Mayo Clin Div Gastroenterol &

    Hepatol Dev Endoscopy Unit 200 First St SW Rochester MN 55905 USA;

    Mayo Clin Div Gastroenterol &

    Hepatol Dev Endoscopy Unit 200 First St SW Rochester MN 55905 USA;

    Mayo Clin Div Gastroenterol &

    Hepatol Dev Endoscopy Unit 200 First St SW Rochester MN 55905 USA;

    Mayo Clin Div Gastroenterol &

    Hepatol Dev Endoscopy Unit 200 First St SW Rochester MN 55905 USA;

    Mayo Clin Div Gastroenterol &

    Hepatol Dev Endoscopy Unit 200 First St SW Rochester MN 55905 USA;

    Mayo Clin Div Gastroenterol &

    Hepatol Dev Endoscopy Unit 200 First St SW Rochester MN 55905 USA;

    Mayo Clin Div Gastroenterol &

    Hepatol Dev Endoscopy Unit 200 First St SW Rochester MN 55905 USA;

    Mayo Clin Div Gastroenterol &

    Hepatol Dev Endoscopy Unit 200 First St SW Rochester MN 55905 USA;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 诊断学;
  • 关键词

    Endoscopic submucosal dissection; Traction; Magnet; Colon; Porcine;

    机译：内窥镜粘膜解剖;牵引力;磁铁;结肠;猪;

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