经皮内镜胃造瘘法胃壁穿透术在自然腔道内镜手术实验中的应用

目的评估经皮内镜下胃造瘘（PEG）法胃壁穿透术在经自然腔道内镜手术（NOTES）中应用的可行性及安全性。方法总结和对比38只实验犬经胃壁入路NOTES（20只行PEG法胃壁穿透术，18只行针刀法胃壁穿透术），在胃壁穿透成功率、术中并发症、操作耗时方面的差异。结果38例次NOTES胃壁入路穿透手术均获成功。PEG法胃壁穿透组实验犬术中无明显出血及周围脏器损伤等并发症，而针刀法胃壁穿透组并发1例胃壁切口大出血、3例损伤临近脏器（0％与22％，P〈0．05），但PEG法胃壁穿透组操作耗时（15．0±3．7）min，比针刀法胃壁穿透组耗时（6．0±1．1）min长。结论PEG法胃壁穿透术在NOTES操作中是安全、有效的，值得推广应用。

Gastrotomy in experimental natural orifice transluminal endoscopic surgery using technique of percutaneous endoscopic gastostomy

Objective To evaluate the feaibility and safety of gastrotomy in natural orifice transluminal endoscopic surgery(NOTES)using technique of percutaneous endoscopic gastostomy(PEG).Methods To retrospectively investigate and compare the success rate,complications and procedure time of gastrotomy in NOTES of dogs between PEG-like approach(PEG group,n =20)and needle knife incision(needle knife group,n =18).Results Gastrotomy was successfully performed in all animals.No mass bleeding or organ injury was observed in PEG group,while one dog in needle knife group encountered mass bleeding,and injuries to the adjacent organs were found in 3 others(0％ in PEG group vs.22％ in needle knife group,P ＜ 0.05).The procedure time of gastrotomy in PEG group was longer than that of needle knife group (15.0±3.7 min vs.6.0 ± 1.1 min,P ＜0.05).Conclusion Compared with the techniqued of needle knife incision,gastrotomy using PEG-like approach in NOTES is safe and feasible.