Endoscopic full-thickness resection: circumferential cutting method.
Identifieur interne : 001B81 ( Main/Exploration ); précédent : 001B80; suivant : 001B82Endoscopic full-thickness resection: circumferential cutting method.
Auteurs : Keiichi Ikeda [Royaume-Uni] ; C Alexander Mosse ; Per-Ola Park ; Annette Fritscher-Ravens ; Maria Bergström ; Tim Mills ; Hisao Tajiri ; C Paul SwainSource :
- Gastrointestinal endoscopy [ 0016-5107 ] ; 2006.
Descripteurs français
- KwdFr :
- MESH :
- anatomopathologie : Tumeurs de l'estomac.
- chirurgie : Tumeurs de l'estomac.
- méthodes : Endoscopie gastrointestinale.
- Animaux, Hémostase endoscopique, Suidae, Techniques de suture, Études de faisabilité.
English descriptors
- KwdEn :
- MESH :
- methods : Endoscopy, Gastrointestinal.
- pathology : Stomach Neoplasms.
- surgery : Stomach Neoplasms.
- Animals, Feasibility Studies, Hemostasis, Endoscopic, Suture Techniques, Swine.
Abstract
BACKGROUND
Endoscopic full-thickness resection (EFTR) at flexible endoscopy might allow less-invasive removal of more deeply penetrating cancers that have not spread to the serosal surface and more complete histologic examination of the excised tissue.
OBJECTIVE
A method for closure of full-thickness defects in the stomach wall would be valuable for other endosurgical applications.
SETTING
A method that uses an end cap and band-ligation without prior injection of saline solution to perform EFTR gave good results and was safe in pig studies. There is a size limitation of cancers that can be resected en bloc when using this method. The depth of resection was also variable.
DESIGN AND INTERVENTIONS
EFTR was achieved by circumferential cutting with a sphincterotome and a snare. A prototype bidirectional cutter was tested. Sutured closure was accomplished by using a sheathed needle, a metal tag, and a thread at the tip, passed through a 2.8-mm accessory channel. Knot-tying devices secured the sutured defect.
MAIN OUTCOME MEASUREMENTS
EFTR was studied in non-survival (n = 4) and survival (n = 8) experiments in pigs.
RESULTS
Full-thickness specimens were resected from the gastric wall (100%, 12/12), and the defects were closed by using sewing and knot-tying devices (100%, 12/12).
LIMITATIONS
A healing ulcer at the suturing site was evident at follow-up endoscopy in the survival experiments. Bleeding, which was stopped by suturing, occurred in 1 pig (8.3%, 1/12). All pigs survived these experiments without complications (100%, 8/8).
CONCLUSIONS
Circumferential EFTR was feasible and appeared safe in survival experiments. This method might allow larger and deeper resection of tumors in the gastric wall.
DOI: 10.1016/j.gie.2005.12.039
PubMed: 16813808
Affiliations:
Links toward previous steps (curation, corpus...)
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uniqKey="Park P" first="Per-Ola" last="Park">Per-Ola Park</name></author><author><name sortKey="Fritscher Ravens, Annette" sort="Fritscher Ravens, Annette" uniqKey="Fritscher Ravens A" first="Annette" last="Fritscher-Ravens">Annette Fritscher-Ravens</name></author><author><name sortKey="Bergstrom, Maria" sort="Bergstrom, Maria" uniqKey="Bergstrom M" first="Maria" last="Bergström">Maria Bergström</name></author><author><name sortKey="Mills, Tim" sort="Mills, Tim" uniqKey="Mills T" first="Tim" last="Mills">Tim Mills</name></author><author><name sortKey="Tajiri, Hisao" sort="Tajiri, Hisao" uniqKey="Tajiri H" first="Hisao" last="Tajiri">Hisao Tajiri</name></author><author><name sortKey="Swain, C Paul" sort="Swain, C Paul" uniqKey="Swain C" first="C Paul" last="Swain">C Paul Swain</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2006">2006</date><idno type="RBID">pubmed:16813808</idno><idno type="pmid">16813808</idno><idno 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London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Mosse, C Alexander" sort="Mosse, C Alexander" uniqKey="Mosse C" first="C Alexander" last="Mosse">C Alexander Mosse</name></author><author><name sortKey="Park, Per Ola" sort="Park, Per Ola" uniqKey="Park P" first="Per-Ola" last="Park">Per-Ola Park</name></author><author><name sortKey="Fritscher Ravens, Annette" sort="Fritscher Ravens, Annette" uniqKey="Fritscher Ravens A" first="Annette" last="Fritscher-Ravens">Annette Fritscher-Ravens</name></author><author><name sortKey="Bergstrom, Maria" sort="Bergstrom, Maria" uniqKey="Bergstrom M" first="Maria" last="Bergström">Maria Bergström</name></author><author><name sortKey="Mills, Tim" sort="Mills, Tim" uniqKey="Mills T" first="Tim" last="Mills">Tim Mills</name></author><author><name sortKey="Tajiri, Hisao" sort="Tajiri, Hisao" uniqKey="Tajiri H" first="Hisao" last="Tajiri">Hisao Tajiri</name></author><author><name sortKey="Swain, C Paul" sort="Swain, C Paul" uniqKey="Swain C" first="C Paul" last="Swain">C Paul Swain</name></author></analytic><series><title level="j">Gastrointestinal endoscopy</title><idno type="ISSN">0016-5107</idno><imprint><date when="2006" type="published">2006</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Animals (MeSH)</term><term>Endoscopy, Gastrointestinal (methods)</term><term>Feasibility Studies (MeSH)</term><term>Hemostasis, Endoscopic (MeSH)</term><term>Stomach Neoplasms (pathology)</term><term>Stomach Neoplasms (surgery)</term><term>Suture Techniques (MeSH)</term><term>Swine (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Animaux (MeSH)</term><term>Endoscopie gastrointestinale (méthodes)</term><term>Hémostase endoscopique (MeSH)</term><term>Suidae (MeSH)</term><term>Techniques de suture (MeSH)</term><term>Tumeurs de l'estomac (anatomopathologie)</term><term>Tumeurs de l'estomac (chirurgie)</term><term>Études de faisabilité (MeSH)</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Tumeurs de l'estomac</term></keywords><keywords scheme="MESH" qualifier="chirurgie" xml:lang="fr"><term>Tumeurs de l'estomac</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Endoscopy, Gastrointestinal</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Endoscopie gastrointestinale</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Stomach Neoplasms</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Stomach Neoplasms</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Animals</term><term>Feasibility Studies</term><term>Hemostasis, Endoscopic</term><term>Suture Techniques</term><term>Swine</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Animaux</term><term>Hémostase endoscopique</term><term>Suidae</term><term>Techniques de suture</term><term>Études de faisabilité</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Endoscopic full-thickness resection (EFTR) at flexible endoscopy might allow less-invasive removal of more deeply penetrating cancers that have not spread to the serosal surface and more complete histologic examination of the excised tissue.</p></div><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>A method for closure of full-thickness defects in the stomach wall would be valuable for other endosurgical applications.</p></div><div type="abstract" xml:lang="en"><p><b>SETTING</b></p><p>A method that uses an end cap and band-ligation without prior injection of saline solution to perform EFTR gave good results and was safe in pig studies. There is a size limitation of cancers that can be resected en bloc when using this method. The depth of resection was also variable.</p></div><div type="abstract" xml:lang="en"><p><b>DESIGN AND INTERVENTIONS</b></p><p>EFTR was achieved by circumferential cutting with a sphincterotome and a snare. A prototype bidirectional cutter was tested. Sutured closure was accomplished by using a sheathed needle, a metal tag, and a thread at the tip, passed through a 2.8-mm accessory channel. Knot-tying devices secured the sutured defect.</p></div><div type="abstract" xml:lang="en"><p><b>MAIN OUTCOME MEASUREMENTS</b></p><p>EFTR was studied in non-survival (n = 4) and survival (n = 8) experiments in pigs.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Full-thickness specimens were resected from the gastric wall (100%, 12/12), and the defects were closed by using sewing and knot-tying devices (100%, 12/12).</p></div><div type="abstract" xml:lang="en"><p><b>LIMITATIONS</b></p><p>A healing ulcer at the suturing site was evident at follow-up endoscopy in the survival experiments. Bleeding, which was stopped by suturing, occurred in 1 pig (8.3%, 1/12). All pigs survived these experiments without complications (100%, 8/8).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Circumferential EFTR was feasible and appeared safe in survival experiments. This method might allow larger and deeper resection of tumors in the gastric wall.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">16813808</PMID><DateCompleted><Year>2006</Year><Month>09</Month><Day>05</Day></DateCompleted><DateRevised><Year>2006</Year><Month>11</Month><Day>15</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0016-5107</ISSN><JournalIssue CitedMedium="Print"><Volume>64</Volume><Issue>1</Issue><PubDate><Year>2006</Year><Month>Jul</Month></PubDate></JournalIssue><Title>Gastrointestinal endoscopy</Title><ISOAbbreviation>Gastrointest Endosc</ISOAbbreviation></Journal><ArticleTitle>Endoscopic full-thickness resection: circumferential cutting method.</ArticleTitle><Pagination><MedlinePgn>82-9</MedlinePgn></Pagination><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Endoscopic full-thickness resection (EFTR) at flexible endoscopy might allow less-invasive removal of more deeply penetrating cancers that have not spread to the serosal surface and more complete histologic examination of the excised tissue.</AbstractText><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">A method for closure of full-thickness defects in the stomach wall would be valuable for other endosurgical applications.</AbstractText><AbstractText Label="SETTING" NlmCategory="METHODS">A method that uses an end cap and band-ligation without prior injection of saline solution to perform EFTR gave good results and was safe in pig studies. There is a size limitation of cancers that can be resected en bloc when using this method. The depth of resection was also variable.</AbstractText><AbstractText Label="DESIGN AND INTERVENTIONS" NlmCategory="METHODS">EFTR was achieved by circumferential cutting with a sphincterotome and a snare. A prototype bidirectional cutter was tested. Sutured closure was accomplished by using a sheathed needle, a metal tag, and a thread at the tip, passed through a 2.8-mm accessory channel. Knot-tying devices secured the sutured defect.</AbstractText><AbstractText Label="MAIN OUTCOME MEASUREMENTS" NlmCategory="METHODS">EFTR was studied in non-survival (n = 4) and survival (n = 8) experiments in pigs.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Full-thickness specimens were resected from the gastric wall (100%, 12/12), and the defects were closed by using sewing and knot-tying devices (100%, 12/12).</AbstractText><AbstractText Label="LIMITATIONS" NlmCategory="CONCLUSIONS">A healing ulcer at the suturing site was evident at follow-up endoscopy in the survival experiments. Bleeding, which was stopped by suturing, occurred in 1 pig (8.3%, 1/12). All pigs survived these experiments without complications (100%, 8/8).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Circumferential EFTR was feasible and appeared safe in survival experiments. This method might allow larger and deeper resection of tumors in the gastric wall.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ikeda</LastName><ForeName>Keiichi</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Surgical Oncology and Technology, St Mary's Hospital, 41 Willow Road, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mosse</LastName><ForeName>C Alexander</ForeName><Initials>CA</Initials></Author><Author ValidYN="Y"><LastName>Park</LastName><ForeName>Per-Ola</ForeName><Initials>PO</Initials></Author><Author ValidYN="Y"><LastName>Fritscher-Ravens</LastName><ForeName>Annette</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Bergström</LastName><ForeName>Maria</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Mills</LastName><ForeName>Tim</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Tajiri</LastName><ForeName>Hisao</ForeName><Initials>H</Initials></Author><Author ValidYN="Y"><LastName>Swain</LastName><ForeName>C Paul</ForeName><Initials>CP</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Gastrointest Endosc</MedlineTA><NlmUniqueID>0010505</NlmUniqueID><ISSNLinking>0016-5107</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Gastrointest Endosc. 2006 Jul;64(1):90-1</RefSource><PMID Version="1">16813809</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000818" MajorTopicYN="N">Animals</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016099" MajorTopicYN="N">Endoscopy, Gastrointestinal</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005240" MajorTopicYN="N">Feasibility Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016558" MajorTopicYN="N">Hemostasis, Endoscopic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013274" MajorTopicYN="N">Stomach Neoplasms</DescriptorName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D013536" MajorTopicYN="N">Suture Techniques</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013552" MajorTopicYN="N">Swine</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2005</Year><Month>09</Month><Day>23</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2005</Year><Month>12</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2006</Year><Month>7</Month><Day>4</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2006</Year><Month>9</Month><Day>6</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2006</Year><Month>7</Month><Day>4</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">16813808</ArticleId><ArticleId IdType="pii">S0016-5107(06)00143-X</ArticleId><ArticleId IdType="doi">10.1016/j.gie.2005.12.039</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement></list><tree><noCountry><name sortKey="Bergstrom, Maria" sort="Bergstrom, Maria" uniqKey="Bergstrom M" first="Maria" last="Bergström">Maria Bergström</name><name sortKey="Fritscher Ravens, Annette" sort="Fritscher Ravens, Annette" uniqKey="Fritscher Ravens A" first="Annette" last="Fritscher-Ravens">Annette Fritscher-Ravens</name><name sortKey="Mills, Tim" sort="Mills, Tim" uniqKey="Mills T" first="Tim" last="Mills">Tim Mills</name><name sortKey="Mosse, C Alexander" sort="Mosse, C Alexander" uniqKey="Mosse C" first="C Alexander" last="Mosse">C Alexander Mosse</name><name sortKey="Park, Per Ola" sort="Park, Per Ola" uniqKey="Park P" first="Per-Ola" last="Park">Per-Ola Park</name><name sortKey="Swain, C Paul" sort="Swain, C Paul" uniqKey="Swain C" first="C Paul" last="Swain">C Paul Swain</name><name sortKey="Tajiri, Hisao" sort="Tajiri, Hisao" uniqKey="Tajiri H" first="Hisao" last="Tajiri">Hisao Tajiri</name></noCountry><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Ikeda, Keiichi" sort="Ikeda, Keiichi" uniqKey="Ikeda K" first="Keiichi" last="Ikeda">Keiichi Ikeda</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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