編者按:近日,在DDW2012上,南京醫科大學消化內鏡研究所所長、消化醫學中心主任範誌寧教授在大會上報道其創新內鏡研究成果。感謝範誌寧教授、張發明副教授接受醫學論壇網消化頻道的約稿邀請,特別感謝張發明副教授對本文的貢獻。
範誌寧 教授
Natural Orifice Trans-Pharyngeal Diverticulum Thoracic Sympathectomy:a Pilot Study in Animal Model
Fan Zhi-ning, Tang X. Wei, Xiang Wang
Background and objective: Thoracoscopic sympathectomy is now widely used for the surgical treatment for patients with disabling palmar hyperhidrosis. This method requires a transthoracic approach to permit ablation of the thoracic sympathetic chain. We tried to develop a less invasive, trans-pharyngeal diverticulum endoscopic technique for a sympathectomy in the swine model.
Methods:Ten healthy domestic swines were used for this nonsurvival study, followed by autopsy and histological investigation. A double-channel gastroscope was introduced into the pharyngeal diverticulum, then a biopsy forcep and balloon were used to create a small pharyngeal diverticulum perforation, through which the gastroscope entered into the mediastinum and chest. The sympathetic chain was identified at the 3 or 4 thoracic level and was ablated or transected. After the completion of the procedure, the animals were killed.
Result:The ablation of sympathetic chain was successfully completed in 9 of 10 swine, as confirmed by autopsy and histology. In 1 swine, muscle fibers were inadvertently transected. On average, it took 56.1 21.3 minutes to get into the chest, whereas the sympathectomy was performed in less than 4 minutes in all cases. During the whole procedure, there was no major complictions happened in the swines.
Conclusion:Natural orifice trans-pharyngeal diverticulum thoracic sympathectomy is technically feasible, simple, and can be performed in a porcine model.
(南京醫科大學第二附屬醫院消化醫學中心,南京醫科大學消化內鏡研究所教授 範誌寧)
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專題鏈接:2012美國消化疾病周專題