Endoscopic ultrasound-assisted direct peritoneal visualization with a small-caliber scope: A proof of concept study in a swine model.
Endoscopic ultrasound-assisted direct peritoneal visualization with a small-caliber scope: A proof of concept study in a swine model.
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DOI：
10.4103/2303-9027.144535
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发表时间：
2014-10
影响因子：
4.5
通讯作者：
Ohira H
中科院分区：
文献类型：
--
作者：
Suzuki R;Bhutani MS;Shin D;Irisawa A;Fleming JB;Richards-Kortum R;Ohira H
腹腔镜和经自然腔道内镜手术技术可以诊断提示肿瘤细胞播散的腹膜发现。然而，主要由于其复杂性，尚未将其纳入常规做法。为了开发一种用于诊断腹膜病变的微创内镜技术，我们使用急性猪模型进行了可行性研究。这项研究涉及6头家猪。采用内镜超声细针抽吸（EUS-FNA）技术经胃进入腹膜腔。用胆道扩张导管和球囊扩张针孔后，将小口径内窥镜插入腹腔。腹膜图像获得的范围和高分辨率显微内窥镜（HRME）。主要结果测量是技术可行性和进入腹膜腔所需的时间。在所有6只猪中，腹膜的直接可视化均获得成功，并可进入腹膜腔的大体外观。局部造影剂的HRME成像也获得了合理质量的图像，代表腹膜间皮细胞核。从开始EUS-FNA到获取腹膜图像的平均手术时间为26.5 min（范围15-40 min）。尸检发现邻近器官无损伤，胃壁缺损用止血夹紧密闭合。小口径内镜下超声内镜辅助腹膜直接显像技术可行。HRME可辅助腹膜检查结果的诊断。
Laparoscopic and natural orifice transluminal endoscopic surgery techniques can diagnose peritoneal findings that suggest tumor cell dissemination. However, they have not been incorporated into routine practice, mainly owing to their complexity. To develop a minimally invasive endoscopic technique for the diagnosis of peritoneal findings, we conducted feasibility study using an acute swine model. This study involved six domestic pigs. Trans-gastric access to the peritoneal cavity was performed utilizing an endoscopic ultrasound fine needle aspiration (EUS-FNA) technique. After dilation of the needle hole with a biliary dilatation catheter and balloon, a small-caliber scope was inserted into the peritoneal cavity. Peritoneal images were obtained with the scope and a high-resolution microendoscope (HRME). Main outcome measurements were technical feasibility and time needed to access the peritoneal cavity. Direct visualization of the peritoneum was successful in all six pigs and gained access to the gross appearance of the peritoneal cavity. HRME imaging with topical contrast agent also obtained reasonable quality images representing nuclei of the peritoneal mesothelium. Average operation time from the initiation of EUS-FNA to acquiring peritoneal images was 26.5 min (range 15-40 min). Autopsy found no damage to the adjacent organs, and stomach wall defects were tightly closed with hemostasis clips. EUS-assisted direct peritoneal visualization with small-caliber scope is technically feasible. HRME may assist in the diagnosis of findings on the peritoneum.
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DOI：
10.1007/s10120-003-0257-0
发表时间：
2003-01-01
期刊：
Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association
影响因子：
--
作者：
Blackshaw, Guy R J C;Barry, Jonathan D;Lewis, Wyn G
通讯作者：
Lewis, Wyn G
影响因子：
7.7
作者：
Mcgee, Michael E.;Marks, Jeffrey M.;Ponsky, Jeffrey L.
通讯作者：
Ponsky, Jeffrey L.
DOI：
10.1007/s00464-008-9811-5
发表时间：
2008-05-01
影响因子：
3.1
作者：
Palanivelu, Chinnusamy;Rajan, Pidigu Seshiyer;Prasad, Mohan
通讯作者：
Prasad, Mohan
影响因子：
--
作者：
Saftoiu, Adrian;Bhutani, Manoop S.;Fleming, Jason B.
通讯作者：
Fleming, Jason B.
影响因子：
3
作者：
FREENY, PC;TRAVERSO, LW;RYAN, JA
通讯作者：
RYAN, JA