Feasibility Study of EUS-NOTES as a Novel Approach for Pancreatic Cancer Staging and Therapy: An International Collaborative Study
Feasibility Study of EUS-NOTES as a Novel Approach for Pancreatic Cancer Staging and Therapy: An International Collaborative Study
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DOI：
10.5754/hge11774
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发表时间：
2013-01-01
影响因子：
--
通讯作者：
Fleming, Jason B.
中科院分区：
文献类型：
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作者：
Saftoiu, Adrian;Bhutani, Manoop S.;Fleming, Jason B.
背景/目的：EUS引导的自然孔腔内镜手术（NOTES）可能是胰腺手术的潜在可行方法。EUS引导下经胃壁入路可能被证明是进入胰腺的安全有效方法。本研究的目的是评估胰腺前后入路NOTES期间EUS引导的诊断和治疗程序。方法学：通过前面的EUS引导经胃入路进行腹腔镜检查的可行性，以及通过后面的EUS引导经胃入路直接进入胰腺的可行性进行了测试，以便于进入胰腺尾部。最后，使用各种市售和原型内窥镜附件在几只动物中进行胃伤口闭合。结果如下：结果表明，EUS-NOTES技术能够促进经胃入路，并提供胰腺的前后入路。借助EUS引导的T标签插入，通过EUS识别胰尾，以及胰尾的后部入路和后续检查/解剖也是可能的。结论：通过EUS引导的NOTES手术在技术上可以实现NOTES经胃腹腔镜和直接胰腺内镜手术的系统性前后入路。
Background/Aims: EUS guided Natural Orifice Transluminal Endoscopic Surgery (NOTES) could be a potentially viable approach for pancreatic surgery. EUS-guided access through the stomach wall may prove to be a safe and effective method for accessing the pancreas. The aim of the study was to assess the EUS-guided diagnostic and therapeutic procedures during NOTES for both anterior and posterior approach of the pancreas. Methodology: The feasibility of peritoneoscopy through an anterior EUS-guided transgastric approach, as well as direct access to the pancreas through a posterior EUS-guided transgastric approach was tested for ease of access to the tail of the pancreas. Gastric wound closure was finally performed in several animals using various commercial and prototype endoscopic accessories. Results: The results showed the ability of EUS-NOTES technology to facilitate a transgastric approach and provide both an anterior and posterior access the pancreas. Identification the pancreatic tail by EUS with the aid of EUS-guided T-tag insertion, as well as posterior access and subsequent inspection/dissection of the pancreatic tail may also be possible. Conclusions: It is technically possible by EUS-guided NOTES procedures to achieve a systematic anterior and posterior access for NOTES transgastric peritoneoscopy and direct pancreatic endoscopic procedures.