Endoscopic ultrasound-guided puncture suture device versus metal clip for gastric defect closure after endoscopic full-thickness resection: A randomized, comparative, porcine study.
Endoscopic ultrasound-guided puncture suture device versus metal clip for gastric defect closure after endoscopic full-thickness resection: A randomized, comparative, porcine study.
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DOI：
10.4103/2303-9027.187891
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发表时间：
2016-07
影响因子：
4.5
通讯作者：
Feng L
中科院分区：
文献类型：
--
作者：
Sun B;Guo J;Ge N;Sun S;Wang S;Liu X;Wang G;Feng L
壁缺损的安全闭合是内镜全层切除术（EFTR）的关键阶段。本研究的目的是在一项随机、比较性猪研究中，比较使用内窥镜超声引导穿刺缝合装置 (PSD) 与金属夹 (MC) 技术对 EFTR 后缺损的闭合情况。我们进行了一项随机比较生存研究，其中包括 18 头猪。直径约为 20 mm 的圆形 EFTR 缺陷用 PSD 或 MC 封闭。术前和术后第 1、3 和 7 天测定白细胞介素 6 (IL-6) 的血清水平。在第 7、14 和 30 个 POD 结束时处死每组 3 只动物。从闭合部位取回的组织样本进行了宏观和微观检查。 18 头猪（100%）进行了切除和闭合，没有出现严重的围手术期并发症。 MC 组的平均闭合时间明显长于 PSD 组（25.00 ± 3.16 分钟 vs. 1.56 ± 0.39 分钟；P < 0.05）。术前和 POD 7 血清 IL-6 水平在两组之间没有差异。然而，在 POD 1 时，观察到 MC 组的 IL-6 水平显着高于 PSD 组（P < 0.005）。尸检时未观察到 PSD 组和 MC 组之间存在显着差异。在此体内猪模型中，PSD 是一种可行的装置，与 MC 技术相比，它可以以更短的闭合时间和更少的免疫反应实现 EFTR 后缺损闭合。
The secure closure of the wall defect is a critical stage of endoscopic full-thickness resection (EFTR). The aim of this study was to compare the closure of post-EFTR defects using an endoscopic ultrasound-guided puncture suture device (PSD) with the metal clip (MC) technique in a randomized, comparative, porcine study. We performed a randomized comparative survival study that included 18 pigs. The circular EFTR defects with a diameter of approximately 20 mm were closed with either a PSD or MC. Serum levels of interleukin-6 (IL-6) were determined preoperatively and on a postoperative day (POD) 1, 3, and 7. Three animals from each group were sacrificed at the end of the 7th, 14th, and 30th POD. Tissue samples retrieved from the closure sites were examined macroscopically and microscopically. Resection and closure were performed in 18 pigs (100%) without major perioperative complications. The mean closure time was significantly longer in the MC group than in the PSD group (25.00 ± 3.16 min vs. 1.56 ± 0.39 min; P < 0.05). Preoperative and POD 7 serum levels of IL-6 did not differ between the two groups. However, on POD 1, the IL-6 levels were observed to be significantly greater in the MC group than in the PSD group (P < 0.005). No significant differences between the PSD and MC groups were observed at necropsy. In this in vivo porcine model, PSD is a feasible device that achieves post-EFTR defect closure with a much shorter closure time and with less immunological responses than the MC technique.