经食管隧道内镜纵隔探查术的动物实验研究  

An Animal Study on Endoscopic Mediastinal Exploration via Esophageal Submucosal Tunnel

作　　者：夏幼辰 夏杰 龚晓媛 程礼[1] 宛新建[1,3] XIA Youchen;XIA Jie;GONG Xiaoyuan;CHENG Li;WAN Xinjian(Department of Gastroenterology and Hepatology,Shanghai Jiao Tong University,Shanghai 201620;Department of Gastroenterology and Hepatology,Changzhou Second People’s Hospital,Nanjing Medical University,Changzhou,Jiangsu Province;Gastrointestinal Endoscopy Center,Shanghai General Hospital,Shanghai Jiao Tong University,Shanghai 201620)

机构地区：[1]上海交通大学附属第一人民医院消化科,201620 [2]南京医科大学附属常州第二人民医院消化科 [3]上海交通大学附属第一人民医院消化内镜中心,201620

出　　处：《胃肠病学》2019年第1期17-20,共4页Chinese Journal of Gastroenterology

摘　　要：背景:目前内镜隧道技术用于消化道腔外手术有诸多问题仍存在争议。目的:探讨经食管隧道内镜纵隔探查术的可行性和安全性。方法:采用实验用家猪,建立食管黏膜下隧道,行经食管隧道内镜纵隔探查术,术后以止血夹封闭食管黏膜创面,予青霉素预防感染。2周后复查胃镜,处死实验动物,取食管标本进行大体和组织学检查。观察实验动物存活率以及创面愈合和并发症发生情况。结果:术中能清晰探及主动脉、气管、心包等纵隔内器官,术后实验动物均存活,无明显并发症发生。2周后胃镜复查和解剖标本组织学检查提示创面愈合良好。经与尸检结果比对,内镜下定位相应解剖结构准确。结论:经食管隧道内镜纵隔探查术具有一定的可行性且相对安全。Background:Currently,many problems are still controversial on performing out of digestive tract operation through endoscopic submucosal tunnel.Aims:To evaluate the feasibility and safety of endoscopic mediastinal exploration via esophageal submucosal tunnel.Methods:Endoscopic mediastinal exploration was performed via esophageal submucosal tunnel in two healthy swine.A 5cm submucosal tunnel was created with blunt dissection.The mucosal incision was closed by hemostatic clips,and penicillin was used prophylactically.Two weeks later,after reexamined by gastroscopy,the animals were sacrificed and the esophagus was obtained for macropathology and histopathology.The survival rate,wound healing and complications were observed.Results:The mediastinal organs such as aorta,trachea,and pericardium were identified clearly during exploration.All the animals survived with no obvious complications.Gastroscopy and histopathology showed good wound healing two weeks after operation.Taking autopsy as standard,the anatomical structures were accurately identified under endoscopy.Conclusions:Animal experiment revealed that mediastinal exploration via transesophageal endoscopic submucosal tunnel is feasible and relatively safe.

关 键 词：内镜隧道技术 纵隔镜检查 自然腔道内镜手术 猪 

分 类 号：R57[医药卫生—消化系统]