Improved endoscopic resection of large flat lesions and early cancers using an external additional working channel (AWC): a case series
Improved endoscopic resection of large flat lesions and early cancers using an external additional working channel (AWC): a case series
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DOI：
10.1055/a-0824-6912
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发表时间：
2019-02-01
影响因子：
2.6
通讯作者：
Meining, Alexander
中科院分区：
文献类型：
--
作者：
Walter, Benjamin;Schmidbaur, Simone;Meining, Alexander
背景：对大的扁平病灶或早期癌症进行整块切除是一项挑战。使用标准内窥镜无法执行双手操作。双通道内窥镜并不是随处可得的，并且通道之间的距离很小。患者和方法设计并开发了一种新的外部附加工作通道（AWC）（Ovesco，Tuebingen，德国），可能使双手任务成为可能。固定到一个标准的胃镜或小儿结肠镜的尖端，第二个内窥镜工具可以插入通过AWC和用于组织收缩在内镜receivation.Results在上，下消化道，内镜粘膜切除术（EMR）与一个修改后的抓圈套技术和内镜粘膜下剥离术（ESD）成功地进行了使用AWC在8例患者。并发症是急性动脉出血后EMR在两例治疗内镜clipping.Conclusions，我们的结论是，一个新开发的外部额外的工作通道（AWC），使内镜切除大型病变在上，下消化道。潜在的好处是它适用于EMR和ESD，不需要双通道内窥镜和可调节的工作通道距离。
Background En-bloc resection of large, flat lesions or early stages of cancer is challenging. No bimanual tasks are possible using standard endoscopes. Dual-channel endoscopes are not available everywhere and have a small distance between the channels.Patients and methods A new external additional working channel (AWC) (Ovesco, Tuebingen, Germany) was designed and developed potentially enabling bimanual tasks. Fixed to the tip of a standard gastroscope or pediatric colonoscope, a second endoscopic tool can be inserted through the AWC and used for tissue retraction during endoscopic resection.Results In the upper and lower gastrointestinal tract, endoscopic mucosal resection (EMR) with a modified grasp-and-snare technique and endoscopic submucosal dissection (ESD) were performed successfully using the AWC in eight patients. Complications were acute arterial bleeding post-EMR in two cases treated by endoscopic clipping.Conclusions We conclude that a newly developed external additional working channel (AWC) enables endoscopic resection of large lesions in the upper and lower gastrointestinal tract. Potential benefits are its suitability for EMR and ESD, no need for a dual-channel endoscope and an adjustable distance of working channels.