Percutaneous transgastric endoscopic tube ileostomy in a porcine survival model.

Autor:	Shi H; Hong Shi, Su-Yu Chen, Zhao-Fei Xie, Department of Gastrointestinal Endoscopy, Fujian Provincial Cancer Hospital, Affiliated Cancer Hospital of Fujian Medical University, Fuzhou 350014, Fujian Province, China., Chen SY; Hong Shi, Su-Yu Chen, Zhao-Fei Xie, Department of Gastrointestinal Endoscopy, Fujian Provincial Cancer Hospital, Affiliated Cancer Hospital of Fujian Medical University, Fuzhou 350014, Fujian Province, China., Wang YG; Hong Shi, Su-Yu Chen, Zhao-Fei Xie, Department of Gastrointestinal Endoscopy, Fujian Provincial Cancer Hospital, Affiliated Cancer Hospital of Fujian Medical University, Fuzhou 350014, Fujian Province, China., Jiang SJ; Hong Shi, Su-Yu Chen, Zhao-Fei Xie, Department of Gastrointestinal Endoscopy, Fujian Provincial Cancer Hospital, Affiliated Cancer Hospital of Fujian Medical University, Fuzhou 350014, Fujian Province, China., Cai HL; Hong Shi, Su-Yu Chen, Zhao-Fei Xie, Department of Gastrointestinal Endoscopy, Fujian Provincial Cancer Hospital, Affiliated Cancer Hospital of Fujian Medical University, Fuzhou 350014, Fujian Province, China., Lin K; Hong Shi, Su-Yu Chen, Zhao-Fei Xie, Department of Gastrointestinal Endoscopy, Fujian Provincial Cancer Hospital, Affiliated Cancer Hospital of Fujian Medical University, Fuzhou 350014, Fujian Province, China., Xie ZF; Hong Shi, Su-Yu Chen, Zhao-Fei Xie, Department of Gastrointestinal Endoscopy, Fujian Provincial Cancer Hospital, Affiliated Cancer Hospital of Fujian Medical University, Fuzhou 350014, Fujian Province, China., Dong FF; Hong Shi, Su-Yu Chen, Zhao-Fei Xie, Department of Gastrointestinal Endoscopy, Fujian Provincial Cancer Hospital, Affiliated Cancer Hospital of Fujian Medical University, Fuzhou 350014, Fujian Province, China.
Jazyk:	angličtina
Zdroj:	World journal of gastroenterology [World J Gastroenterol] 2016 Oct 07; Vol. 22 (37), pp. 8375-8381.
DOI:	10.3748/wjg.v22.i37.8375
Abstrakt:	Aim: To introduce natural orifice transgastric endoscopic surgery (NOTES) tube ileostomy using pelvis-directed submucosal tunneling endoscopic gastrostomy and endoscopic tube ileostomy. Methods: Six live pigs (three each in the non-survival and survival groups) were used. A double-channeled therapeutic endoscope was introduced perorally into the stomach. A gastrostomy was made using a 2-cm transversal mucosal incision following the creation of a 5-cm longitudinal pelvis-directed submucosal tunnel. The pneumoperitoneum was established via the endoscope. In the initial three operations of the series, a laparoscope was transumbilically inserted for guiding the tunnel direction, intraperitoneal spatial orientation and distal ileum identification. Endoscopic tube ileostomy was conducted by adopting an introducer method and using a Percutaneous Endoscopic Gastrostomy Catheter Kit equipped with the Loop Fixture. The distal tip of the 15 Fr catheter was placed toward the proximal limb of the ileum to optimize intestinal content drainage. Finally, the tunnel entrance of the gastrostomy was closed using nylon endoloops with the aid of a twin grasper. The gross and histopathological integrity of gastrostomy closure and the abdominal wall-ileum stoma tract formation were assessed 1 wk after the operation. Results: Transgastric endoscopic tube ileostomy was successful in all six pigs, without major bleeding. The mean operating time was 71 min (range: 60-110 min). There were no intraoperative complications or hemodynamic instability. The post-mortem, which was conducted 1-wk postoperatively, showed complete healing of the gastrostomy and adequate stoma tract formation of ileostomy. Conclusion: Transgastric endoscopic tube ileostomy is technically feasible and reproducible in an animal model, and this technique is worthy of further improvement. Competing Interests: Conflict-of-interest statement: To the best of our knowledge, no conflict of interest exists.
Databáze:	MEDLINE
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