Comparative Study of NOTES Versus Endoscopic Ultrasound Gastrojejunostomy in Pigs: A Prospective Study
| Autor: | Adrian Saftoiu, Bogdan Silviu Ungureanu, Carmen D. Nicolau, Valeriu Șurlin, Ștefan Pătrașcu, Catalin Copaescu, Alice Nicoleta Dragoescu |
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| Rok vydání: | 2017 |
| Předmět: |
Natural Orifice Endoscopic Surgery
Endoscopic ultrasound medicine.medical_specialty Swine Gastric bypass Gastric Bypass Endosonography 03 medical and health sciences 0302 clinical medicine Flexible endoscopy medicine Animals Prospective Studies Prospective cohort study medicine.diagnostic_test business.industry Stomach Gastric outlet obstruction medicine.disease Gastrojejunal anastomosis Surgery Jejunum medicine.anatomical_structure 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology business |
| Zdroj: | Surgical Innovation. 25:16-21 |
| ISSN: | 1553-3514 1553-3506 |
| DOI: | 10.1177/1553350617748278 |
| Popis: | Surgical gastrojejunal anastomosis (GJJ) is considered the standard palliative option for gastric outlet obstruction. The use of endoscopic GJJ has generated a lot of attention and has enlarged the horizon for patients with open surgery contraindications. Our study aimed to assess and compare 2 purely endoscopic GJJ approaches using a lumen-apposing hot tip double-flanged metal stent, with focus on technical and clinical success rates on experimental animals.Two endoscopic GJJ techniques using a double-flanged self-expandable metal stent were compared on 8 pigs. Natural orifice transluminal endoscopic surgery (NOTES) was used on 4 pigs, while the other group was subjected to an endoscopic ultrasound (EUS) balloon-guided approach.On a 21-day follow-up, both EUS and NOTES-GJJ were technically successful in all experimental animals, and necropsy confirmed full integrity of the anastomosis. Adhesions were confirmed only on 2 pigs after NOTES procedure. The mean time for GJJ-NOTES completion was 31.375 ± 2.03, whereas EUS-GJJ was completed with a median time of 20.275 ± 0.65. The stent distance from the stomach varied; in NOTES-GJJ it was 47.8 ± 11.13 cm away from the pylorus, whereas in EUS-GJJ was at 37 ± 1.85 cm.No major complications were encountered during both procedures. EUS-GJJ balloon-guided approach might be a more attractive technique by using sonographic guidance, because of less endoscopic instrument changing as well as in achieving the desired anastomotic distance. |
| Databáze: | OpenAIRE |
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