PDF(Pubmed)
Abstract：
Iatrogenic stomach perforation is a detrimental, irreversible, and fatal condition. Traditional surgery and endoscopic suturing clips and devices have been introduced to seal holes and prevent sepsis and disease progression. However, the development of endoscopic devices for perforations remains challenging, with no standard device available. This study investigates the superficial layer approximation strengths of the newly designed ENDOCRAB system for gastric wall defects. Thirty porcine stomachs were prepared ex vivo for the perforation model and distributed equally into three groups: ENDOCRAB system, Through-the-Scope Clip (TTSC), and hand suturing (HS). Both ENDOCRAB and TTSC achieved mucosal-submucosal layer apposition, whereas HS allowed a full-thickness layer. Their air leakage pressure and procedural duration were measured. The analysis of air-leakage pressure demonstrated comparable suture strength between ENDOCRAB (118.5 ± 41.7 mmHg) and HS (127.4 ± 30.2 mmHg, P = 0.812), but inferior strength with TTSC (73.6 ± 21.6 mmHg, P = 0.012). HS achieved the shortest procedural duration, whereas ENDOCRAB and TTSC showed no significant differences. The ENDOCRAB system showed significantly greater strength than the TTSC, was comparable to HS in strength, and required a procedural duration similar to that of the TTSC. Furthermore, long-term in vivo experiments and histological evaluations are essential.
摘要：
医源性胃穿孔是有害的，不可逆转的,和致命的情况。传统的手术和内窥镜缝合夹和装置已被引入以密封孔并防止败血症和疾病进展。然而,用于穿孔的内窥镜装置的发展仍然具有挑战性，没有可用的标准设备。这项研究调查了新设计的ENDOCRAB系统用于胃壁缺损的表面层近似强度。离体制备30个猪胃用于穿孔模型，并平均分为三组：ENDOCRAB系统，通过范围剪辑(TTSC),手缝合（HS）。ENDOCRAB和TTSC均实现了粘膜-粘膜下层并置，而HS允许全厚度层。测量了它们的漏气压力和程序持续时间。漏气压力分析表明,ENDOCRAB(118.5±41.7mmHg)与HS(127.4±30.2mmHg,P=0.812),但使用TTSC的强度较差(73.6±21.6mmHg，P=0.012)。HS达到了最短的程序持续时间，而ENDOCRAB和TTSC没有显着差异。ENDOCRAB系统显示出比TTSC明显更大的强度，强度与HS相当，并且需要类似于TTSC的程序持续时间。此外，长期体内实验和组织学评估是必不可少的。
