Closure of gastric perforations during endoluminal resection using a novel biodegradable collagen sol: A feasibility survival study on porcine model (with video)
Closure of gastric perforations during endoluminal resection using a novel biodegradable collagen sol: A feasibility survival study on porcine model (with video)
复制标题
使用新型可生物降解胶原溶胶封闭腔内切除术中的胃穿孔：猪模型的可行性生存研究（带视频）
DOI：
10.1111/den.13962
复制
发表时间：
2021
影响因子：
5.3
通讯作者：
Yahagi Naohisa
中科院分区：
文献类型：
--
作者：
Uraoka Toshio;Yunoki Shunji;Sasaki Motoki;Kinoshita Satoshi;Takatori Yusaku;Hirai Yuichiro;Narita Takefumi;Ramberan Hemchand;Shimoda Masayuki;Yahagi Naohisa
一项先前使用猪结肠的研究证明了一种新型注射剂的可行性，温度？一种响应性和可生物降解的胶原溶胶（ICS），其响应于体温从液体转变为凝胶状态，用于在内窥镜切除术（ER）期间进行穿孔的内窥镜闭合。本研究的目的是报告急性和生存的结果ICS胃穿孔在ER.MethodsIn两个实验中，使用9只生猪全身麻醉下，四个和六个穿孔（3 - 5\xA0mm），分别使用电刀在急性和生存实验。使用内窥镜导管将ICS输送至穿孔。在实验1中，在安乐死后对所有被处死的胃进行泄漏试验和组织病理学检查。在实验2中，穿孔部位进行了评估，胃镜检查和组织病理学7，14和28\xA00天后？结果在实验1中，胃镜检查证实ICS完全封闭穿孔，没有泄漏的证据。随后的组织病理学显示胶原凝胶（CG）作为穿孔部位的密封剂固定。没有与ESD或ICS使用相关的不良反应。在实验2中，组织病理学显示固定的CG作为密封剂，更换肉芽组织和无CG;和纤维化组织在7，14和28\xA0days.ConclusionsThis研究提出了一种新的方法，使用ICS，表现出有前途的疗效和安全性的内镜下关闭穿孔在ER。在转化为临床应用之前，还需要进一步的研究。
ObjectiveA prior study using porcine colon demonstrated the feasibility of a novel injectable, temperature?responsive, and biodegradable collagen sol (ICS) that transforms from a liquid to a gel state in response to body temperature for endoscopic closure of perforation during endoscopic resection (ER). This study aims to report the acute and survival outcomes of ICS for gastric perforations during ER.MethodsIn two experiments using nine live pigs under general anesthesia, four and six perforations (3‐5\xA0mm) were created using an electrosurgical knife in acute and survival experiments, respectively. ICS was delivered to the perforations using an endoscopic catheter. In Experiment 1, a leak test and histopathology were performed on all explanted stomachs after euthanization. In Experiment 2, perforation sites were assessed by gastroscopy and histopathology 7, 14 and 28\xA0days post?procedure.ResultsIn Experiment 1, gastroscopy confirmed complete closure of the perforations with ICS and no evidence of leak. Subsequent histopathology revealed a fixation of collagen gel (CG) as a sealant agent at the perforation sites. There were no adverse effects related with ESD or the use of ICS. In Experiment 2, histopathology revealed a fixation of CG as a sealant agent, replacement with granulation tissue and no CG; and fibrotic tissue at 7, 14 and 28\xA0days, respectively.ConclusionsThis study presents a novel method using ICS, demonstrating promising efficacy and safety profile for endoscopic closure of perforations during ER. Further studies are necessary before translating to clinical use.