Adverse events of NOTES mediastinoscopy compared to conventional video-assisted mediastinoscopy: a randomized survival study in a porcine model

Autor: Henry Córdova, Georgina Cubas, Marc Boada, Cristina Rodríguez de Miguel, Graciela Martínez-Pallí, Josep M. Gimferrer, Gloria Fernández-Esparrach
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Zdroj: Endoscopy International Open, Vol 03, Iss 06, Pp E571-E576 (2015)
Druh dokumentu: article
ISSN: 2364-3722
2196-9736
DOI: 10.1055/s-0034-1392599
Popis: Background: Safety is a concern in natural orifice transluminal endoscopic surgery (NOTES) mediastinoscopy. The objective of this study was to compare the safety of NOTES mediastinoscopy with video-assisted mediastinoscopy (VAM). Methods: Twenty-four pigs were randomly assigned to NOTES or VAM. Thirty-minute mediastinoscopies were performed with the identification of seven predetermined structures. The animals were euthanized after 7 days and necropsy was performed. Results: Mediastinoscopy was not possible in one animal in each group. There were more intraoperative adverse events with NOTES than VAM (7 vs. 2, P = 0.04); hemorrhage was the most frequent adverse event (4 and 1, respectively). At necropsy, pathological findings were observed in 13 animals (9 NOTES and 4 VAM; P = 0.03). Inflammatory parameters were not different between groups and were not related to adverse events. Conclusion: Systematic NOTES mediastinoscopy is possible and comparable to VAM in terms of number of organs identified and inflammatory impact. However, the safety profile of NOTES mediastinoscopy has to be improved before it can be adopted in a clinical setting.
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