An ambulant porcine model of acid reflux used to evaluate endoscopic gastroplasty
An ambulant porcine model of acid reflux used to evaluate endoscopic gastroplasty
复制标题
用于评估内镜胃成形术的流动猪胃酸反流模型
作者：
S. Kadirkamanathan;E. Yazaki;D. Evans;C. Hepworth;F. Gong;C. Swain
背景：胃食管反流病治疗方法的试验缺乏合适的模型。内窥镜缝合方法可能允许开发一种新的微创手术方法来治疗胃肠道疾病。目的建立一种胃食管反流动物模型，以测试一种新的抗反流手术的疗效，内镜胃成形术，在不开腹或腹腔镜的情况下在柔性内镜下进行。方法在内窥镜检查时，将pH敏感的无线电遥测胶囊缝在食管下括约肌上方5厘米处的食管壁上。获得动态pH值记录（48-96小时，共447小时）。食管远端中位pH为6.8（范围6.4 ~ 7.3）；9.3%的时间pH值小于4。一周后，内镜下胃成形术，在胃-食管交界处下方缝合，形成1-2厘米长的新食管。术后测压和pH记录（24-96小时，共344小时）。结果：胃成形术后，中括约肌压力从3增加到6 mm Hg，长度从3增加到3.75 cm。pH < 4的中位数时间由9.3%显著降低至0.2%。结论：这是首次对流动猪食管pH值进行长期测量。自发反流的发现为研究反流的治疗提供了一个模型。内镜下胃成形术增加括约肌压力和长度，减少胃酸反流。
BACKGROUND There is a lack of suitable models for testing of therapeutic procedures for gastro-oesophageal reflux disease. Endoscopic sewing methods might allow the development of a new less invasive surgical approach to treatment of gastrointestinal disorders. AIMS To develop an animal model of gastro-oesophageal reflux for testing the efficacy of a new antireflux procedure, endoscopic gastroplasty, performed at flexible endoscopy without laparotomy or laparoscopy. METHODS At endoscopy a pH sensitive radiotelemetry capsule was sewn to the oesophageal wall, 5 cm above the lower oesophageal sphincter, in six large white pigs. Ambulant pH recordings (48–96 hours; total 447 hours) were obtained. The median distal oesophageal pH was 6.8 (range 6.4–7.3); pH was less than 4 for 9.3% of the time. After one week, endoscopic gastroplasty was performed by placing sutures below the gastro-oesophageal junction, forming a neo-oesophagus of 1–2 cm in length. Postoperative manometry and pH recordings (24–96 hours; total 344 hours) were carried out. RESULTS Following gastroplasty, the median sphincter pressure increased significantly from 3 to 6 mm Hg and in length from 3 to 3.75 cm. The median time pH was less than 4 decreased significantly from 9.3% to 0.2%. CONCLUSIONS These are the first long term measurements of oesophageal pH in ambulant pigs. The finding of spontaneous reflux suggested a model for studying treatments of reflux. Endoscopic gastroplasty increased sphincter pressure and length and decreased acid reflux.
影响因子：
9
作者：
Stein,HJ;Barlow,AP;DeMeester,TR;Hinder,RA
通讯作者：
Hinder,RA