Novel Technique for Full-Thickness Resection of Gastric Malignancy: Feasibility of Nonexposed Endoscopic Wall-Inversion Surgery (NEWS) in Porcine Models

作者：Mitsui Takashi; Goto Osamu^*; Shimizu Nobuyuki; Hatao Fumihiko; Wada Ikuo; Niimi Keiko; Asada Hirayama Itsuko; Fujishiro Mitsuihiro; Koike Kazuhiko; Seto Yasuyuki

来源：Surgical Laparoscopy Endoscopy & Percutaneous Techniques, 2013, 23(6): E217-E221.

DOI：10.1097/SLE.0b013e31828e3f94

• full-thickness resection
• laparoscopic and endoscopic cooperative surgery
• nonexposure
• early gastric cancer
• gastric submucosal tumor
• minimally invasive

Full-thickness resection for gastric malignancy carries a risk of peritoneal dissemination due to opening of the gastric lumen. We evaluated the feasibility and safety a novel method of full-thickness resection without transmural communication, called nonexposed endoscopic wall-inversion surgery in ex vivo and in vivo porcine models. Six explanted porcine stomachs and 6 live pigs were used for this study. After marking and submucosal injection around 3 cm simulated lesions, the seromuscular layer was laparoscopically cut and sutured with the lesion inverted to the inside. Consecutively, a mucosubmucosal incision was made endoscopically. Three pigs used for the survival study were monitored for 7 days. All 12 lesions were successfully resected en bloc without perforation. The 3 pigs survived for 1 week without adverse events, and necropsy revealed neither leakage nor abscess formation related to the operation. We demonstrated nonexposed endoscopic wall-inversion surgery to be technically feasible and safe in both ex vivo and in vivo porcine studies.

• 出版日期2013-12