Thermal tissue damage caused by new endoscope model due to light absorption
Thermal tissue damage caused by new endoscope model due to light absorption
复制标题
DOI：
10.1111/jgh.15963
复制
发表时间：
2022-07-25
影响因子：
4.1
通讯作者：
Seno, Hiroshi
中科院分区：
文献类型：
--
作者：
Hiramatsu, Yukiko;Utsumi, Takahiro;Seno, Hiroshi
背景和目的明亮的内镜光源可以提高肠粘膜的可视性。奥林巴斯公司（日本东京）于2020年新推出的内窥镜系统需要进行修改，以防止热诱导的组织损伤，据报道，这种损伤发生在放大色素内窥镜检查期间。我们通过使用新的和以前的内窥镜系统评估染色和未染色猪粘膜的温度升高来研究这种现象的机制。方法使用红外成像技术评估染色（印度墨水，0.05%结晶紫，0.5%亚甲蓝，或0.2%靛蓝胭脂红）和未染色的猪粘膜的表面温度后，接触新的内窥镜系统，然后将其修改（系统-EVIS X1; scope-GIF-EZ 1500），并与以前的内窥镜系统（系统-EVIS EXERAIII; scope-GIF-H190）进行比较。我们对与新型内窥镜接触后用0.05%结晶紫染色的猪粘膜进行了组织学分析，以评价组织损伤程度。结果当新内窥镜与未染色的粘膜接触时，表面温度保持< 40 ℃。但是，当新内窥镜与染色粘膜（除靛蓝胭脂红染色外）接触时，最高表面温度升高至> 70 ℃。组织学分析显示，在内窥镜接触>= 5s $$5s $$的地方，用结晶紫染色的猪上皮形成空腔。使用之前的内窥镜，染色粘膜的最高表面温度保持在约60 ℃以下，未染色粘膜的表面温度保持在30 ℃以下。结论新型色素内镜在放大过程中，光吸收热传递会引起组织热损伤。
Background and Aim Bright endoscopic light sources improve the visibility of the intestinal mucosa. A newly launched endoscopic system developed by Olympus Corporation (Tokyo, Japan) in 2020 required modification to prevent heat-induced tissue damage, which reportedly occurs during magnifying chromoendoscopy. We investigated the mechanism of this phenomenon by evaluating the rise in temperature of stained and unstained porcine mucosa using the new and previous endoscopic systems. Methods Surface temperatures of stained (India ink, 0.05% crystal violet, 0.5% methylene blue, or 0.2% indigo carmine) and unstained porcine mucosa were evaluated using infrared imaging after contact with the new endoscopic system before it was modified (system-EVIS X1; scope-GIF-EZ1500) and compared with a previous endoscopic system (system-EVIS EXERAIII; scope-GIF-H190). We performed histological analysis of the porcine mucosa stained with 0.05% crystal violet after contact with the new endoscope to evaluate the degree of tissue damage. Results Surface temperatures remained < 40 degrees C when the new endoscope was in contact with the unstained mucosa. However, the maximum surface temperature rose to > 70 degrees C when the new endoscope was in contact with the stained mucosa (stained other than indigo carmine). Histological analysis revealed cavity formation in porcine epithelium stained with crystal violet where the endoscope made contact for >= 5s$$ \ge 5\ \mathrm{s} $$. Using the previous endoscope, the maximum surface temperature of stained mucosa remained below approximately 60 degrees C, and the surface temperature of the unstained mucosa remained below 30 degrees C. Conclusions Heat transfer by light absorption could cause heat-induced tissue damage during magnifying chromoendoscopy using the new endoscope.