کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3305425 1210354 2009 10 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Omentoplasty for gastrotomy closure after natural orifice transluminal endoscopic surgery procedures (with video)
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری‌های گوارشی
پیش نمایش صفحه اول مقاله
Omentoplasty for gastrotomy closure after natural orifice transluminal endoscopic surgery procedures (with video)
چکیده انگلیسی

IntroductionThe utility of the greater omentum has not been assessed in transluminal access closure after natural orifice transluminal endoscopic surgery (NOTES) procedures.ObjectiveOur purpose was to evaluate the feasibility, efficacy, and safety of omentoplasty for gastrotomy closure.Methods and ProceduresSurvival experiments in 9 female 40-kg pigs were randomly assigned to 3 groups: group A, endoscopic full-thickness resection (EFTR) for transgastric access and peritoneoscopy without closure; group B, ETFR and peritoneoscopy with omentoplasty (flap of omentum is pulled into the stomach and attached to the gastric mucosa with clips but no clips are used for gastrotomy closure itself); group C, balloon dilation for opening and peritoneoscopy followed by omentoplasty for closure. The animals were observed for 2 weeks and then underwent endoscopy and necropsy with histologic evaluation.ResultsTransgastric opening and peritoneoscopy were achieved in all pigs. In groups B and C, a flap of omentum was easily placed to seal the gastrotomy and then attached to the gastric mucosa with 2 to 5 clips (median 4) in 7 to 20 minutes (median 15 minutes). In group A, peritonitis developed in all animals. In both groups B and C, all animals survived 15 days with no peritonitis and minimal adhesions outside the gastrotomy site. In addition, all achieved complete healing (transmural, n = 4; mucosal ulceration, n = 2) of the gastrotomy site. One animal in group B had an 18-mm abscess in the omental flap.LimitationsAnimal model, small sample size, lack of appropriate controls for group C.ConclusionsOmentoplasty of the gastrotomy site is a technically feasible method to seal balloon-created transgastric access to the peritoneal cavity after NOTES procedures.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Gastrointestinal Endoscopy - Volume 70, Issue 1, July 2009, Pages 131–140
نویسندگان
, , , , , , , , , , , ,