Study of full-thickness endoluminal segmental resection of colon in a porcine colon model (with videos) - 22/08/11
Reprint requests: G. S. Raju, MD, FRCP (UK), FACP, FACG, Center for Endoscopic Research, Education, and Training (CERTAIN), 4.106 McCullough Building, 301 University Blvd, University of Texas Medical Branch, Galveston, TX 77555-0764.Galveston, Texas, USA
Abstract |
Background |
Entrapment injury of the adjacent bowel is frequently encountered during full-thickness endoluminal colon suction-resection.
Objective |
Our purpose was to develop a technique that can create a full-thickness resection of the colon without the risk of entrapment injury to adjacent viscera.
Design |
Pilot study.
Setting |
University medical center.
Patients |
Five pigs.
Interventions |
Traction-resection of the colon was created by using a grasping forceps to pull the colon into a band ligator loaded on a double-channel endoscope, followed by the application of a band, and subsequent snare resection (n = 14). Suction-resection of the colon was created by using a double-channel endoscope loaded with a band ligator (n = 12) and a single-channel endoscope with a band ligator (n = 6).
Main Outcome Measurements |
Number of full-thickness colon resections, frequency of the adjacent bowel and mesenteric injury, and the size of the resections were measured.
Results |
The suction-resection technique resulted in significant injury to adjacent viscera compared with the traction-resection technique (56% vs 0%, P = .0013). The traction-resection method resulted in a significantly larger resection compared with the suction-resection method (mean ± SEM: 2.91 ± 0.3 cm vs 2.1 ± 0.1 cm, P = .024). A double-channel endoscope suction-resection method resulted in a significantly larger resection compared with a single channel suction-resection technique (mean ± SEM: 2.1 ± 0.1 cm vs 0.91 ± 0.2 cm, P = .0022).
Limitations |
None.
Conclusions |
The traction-resection technique is safer than the suction-resection method in removing larger specimens of the colon. In addition, the traction-resection technique reduces the risk of injury of the mesentery or adjacent small intestine.
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| Drs Ijaz Ahmed and Goro Shibukawa contributed equally. The animal studies were approved by the University of Texas Medical Branch, Galveston, Institutional Animal Care and Use Committee, and conducted in a dedicated animal endoscopy laboratory. |
Vol 65 - N° 4
P. 696-702 - avril 2007 Retour au numéro
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