Feasibility and safety of endoscopic full-thickness esophageal wall resection and defect closure: a prospective long-term survival animal study
| Autor: | Tamzin Cuming, Frauke Seehusen, Bjorn Jacobsen, Amir Ghanbari, Erich Kahle, Axel von Herbay, Peter Koehler, Peter Milla, Annette Fritscher-Ravens |
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| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
Swine Forceps Scars Autopsy medicine Animals Radiology Nuclear Medicine and imaging Prospective Studies Abscess business.industry Suture Techniques Gastroenterology Mediastinum medicine.disease Mediastinitis Surgery Esophagectomy Treatment Outcome medicine.anatomical_structure Models Animal Feasibility Studies Esophagoscopy Animal studies medicine.symptom Complication business |
| Zdroj: | Gastrointestinal Endoscopy. 69:1314-1320 |
| ISSN: | 0016-5107 |
| DOI: | 10.1016/j.gie.2008.09.031 |
| Popis: | Background The first experiences with endoscopic closure of esophageal perforations in animal survival studies encouraged us to extend these procedures to full-thickness resections of pieces of the esophageal wall (FTEW). Objective To learn the feasibility, safety, and long-term effects of FTEW removal and defect closure. Design Feasibility animal study. Setting Approved animal facility. Interventions Twelve pigs were used for 3-month survival studies, autopsy, and histologic examination. Resection of a 2-cm piece of wall was performed with needle-knife and forceps/snare. Closure was performed by using prototype endoscopic suturing. Main Outcome Measurements Feasibility and complication assessment of this new endoscopic method. Results There were no complications relating to incision, resection, or closure. All pigs recovered quickly. In 2 animals a larger piece of wall causing a larger defect was removed, resulting in much air penetrating into the mediastinum, causing difficult ventilation. This was resolved with thoracic drain. In 3 of 12 animals a toxic substance slipped into the mediastinum, resulting in an abscess in 1 pig and misfire of an anchor as a result of obscured vision. This caused temporary illness of the animal but not death. Autopsy and histologic study confirmed no mediastinitis and well-healed scars in all but one. Limitation Animal study. Conclusion FTEW has proven to be feasible. Long-term survival demonstrated no mediastinitis and only 1 abscess after contamination of the mediastinum. These first experiences encourage further animal studies because the prospect of endoscopic full-thickness removal of esophageal lesions in patients might be very advantageous. |
| Databáze: | OpenAIRE |
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