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首页> 外文期刊>Surgical Endoscopy >Ultrasonic epithelial ablation of the lower esophagus without stricture formation. A new technique for Barrett's ablation.
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Ultrasonic epithelial ablation of the lower esophagus without stricture formation. A new technique for Barrett's ablation.

机译：食管下部超声上皮消融术无狭窄形成。巴雷特消融的新技术。

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BACKGROUND: The premalignant potential of Barrett's esophagus has stimulated efforts to find a way to ablate the columnar epithelium in order to reheal the area with squamous epithelium, thus obviating the cancer risk. This study describes and evaluates a new technique using ultrasonic energy to ablate the epithelium of the lower esophagus in a porcine model. METHODS: Eight young farm pigs were used to develop the technique of applying a laparoscopic Cavitron Ultrasonic Surgical Aspirator (CUSA) to the lower esophageal mucosa through an operating gastrostomy. A further 11 Yakutan minipigs then underwent CUSA epithelial ablation, followed by a laparoscopic Nissen fundoplication or postoperative acid suppression therapy. We then assessed the healing response in these subjects. RESULTS: Optimal CUSA energy settings enabled complete ablation of the squamous epithelium with preservation of the muscularis mucosa and submucosa. The integrity of the aspirated cells was sufficient for cytological analysis. Healing occurred by squamous regeneration without stricture formation. CONCLUSION: The CUSA technique holds promise for complete ablation of the Barrett's epithelium in a single setting. The unique tissue-selective nature of the ablative process allows complete mucosal reepithelialization without stricture formation.
机译：背景：巴雷特食管的恶变潜能刺激了寻找消融柱状上皮以修复鳞状上皮的方法，从而避免了患癌症的风险。这项研究描述和评估了一种新的技术，该技术利用超声波能量消融猪模型中下食道的上皮。方法：使用八头小猪来开发通过手术胃造口术将腹腔镜Cavitron超声外科手术抽吸器（CUSA）应用于食管下层粘膜的技术。然后再对11只雅库坦小型猪进行CUSA上皮切除，然后进行腹腔镜尼森胃底折叠术或术后抑酸治疗。然后，我们评估了这些受试者的愈合反应。结果：最佳的CUSA能量设置可以完全切除鳞状上皮，并保留肌层粘膜和粘膜下层。抽吸细胞的完整性足以进行细胞学分析。鳞状再生而无狭窄形成而愈合。结论：CUSA技术有望在单一设置中完全切除Barrett上皮。切除过程独特的组织选择性性质允许完整的粘膜再上皮形成而无狭窄形成。

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