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首页> 外文期刊>Surgical Endoscopy >High-pressure jet injection of viscous solutions for endoscopic submucosal dissection: A study on ex vivo pig stomachs
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High-pressure jet injection of viscous solutions for endoscopic submucosal dissection: A study on ex vivo pig stomachs

机译：高压喷射粘稠溶液用于内镜下黏膜下剥离术：离体猪胃的研究

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Background: Long-lasting lifting is a key factor during endoscopic submucosal dissection (ESD) and can be obtained by water-jet injection of saline solution or by injection of viscous macromolecular solutions. Combination of the jet injection and the macromolecular viscous solutions has never been used yet. We assessed the ability of a new water-jet system to inject viscous solutions in direct viewing and in retroflexion. We compared jet injection of saline solution and hyaluronate 0.5 % to perform ESD on ex vivo pig stomachs in order to evaluate the benefits of macromolecular solutions when injected by a jet-injector system. Methods: This is a prospective comparative study in pig stomachs. Using the jet injector, four viscous solutions were tested: hydroxyethyl starch, glycerol mix, hyaluronate sodic (0.5 %), and poloxamer mix. Ten ESDs larger than 25 mm (five in direct viewing and five in retroflexion) and one larger than 10 cm were performed with each solution. ESD with hyaluronate jet injection was then compared with ESD with saline jet injection by performing 50 ESDs in each group. A single, minimally-experienced operator conducted all the procedures. Results: All 145 resections were complete, including all marking points with two perforations. Eleven jet ESDs per solution were conducted without any injection issue. In the second part of the study, when compared with saline, significant benefit of hyaluronate was observed on dissection speed (0.80 vs. 1.08 cm2/min, p 0.001). Conclusion: This is the first report on a jet-injector system allowing injection of macromolecular viscous solutions even with retroflexed endoscope. Jet injection of macromolecular solutions can speed up dissection in comparison with saline, and should now be tested on humans.
机译：背景：持久的提拉是内窥镜下黏膜下剥离术（ESD）的关键因素，可以通过喷水注射盐溶液或通过注射粘性大分子溶液来实现。喷射注射和大分子粘性溶液的组合尚未被使用。我们评估了新的水刀系统在直接观察和后屈时注射粘性溶液的能力。我们比较了盐水注射液和0.5％的透明质酸盐在离体猪胃中进行ESD的效果，以评估通过注射系统注射大分子溶液时的益处。方法：这是在猪胃中进行的前瞻性比较研究。使用喷射注射器测试了四种粘性溶液：羟乙基淀粉，甘油混合物，透明质酸钠（0.5％）和泊洛沙姆混合物。每种溶液均进行10次大于25 mm的ESD（直视时5次，后屈5次），而大于10 cm时一次。然后通过在每组中进行50次ESD，将透明质酸喷射注射的ESD与盐水喷射注射的ESD进行比较。所有操作均由一名经验不足的操作员完成。结果：全部145处切除均已完成，包括所有带有两个穿孔的标记点。每个解决方案进行了11次喷射ESD，没有任何注入问题。在研究的第二部分中，与盐水相比，透明质酸盐在解剖速度上具有显着优势（0.80对1.08 cm2 / min，p <0.001）。结论：这是有关喷射注射器系统的首份报告，该系统即使使用反折内窥镜也可以注射大分子粘性溶液。与盐水相比，喷射注射大分子溶液可以加快解剖速度，现在应该在人体上进行测试。

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