内镜下食管肌层切开术的实验研究

目的：探讨内镜下食管肌层切开术的可行性及安全性。方法：成年家猪4只,镇静麻醉后内镜下食管中上段至贲门下1 cm行肌层纵行电刀切开,钛夹夹闭黏膜。结果：4例术中,1例黏膜小切口隧道成形后,黏膜下切开肌层;2例隧道成形困难,行黏膜纵行切开后切断肌层;1例于上端切口处食管穿孔,钛夹夹闭裂孔后继续纵行切开肌层成功。术后4例动物全部存活。结论：内镜下食管肌层切开术术式可行,远期效果有待研究,穿孔等合并症发生风险较高,但经及时处理可获成功。

Exparical Study of Peroral Endoscopic Myotomy

Objective：To evaluate the feasibility and safety of peroral endoscopic myotomy（POEM）.Methods：POEM was performed in 4 pig.Being paralysed,endoscopic myotomy of circular muscle bundles was carried out from superior esophagus to 1 cm in distal cardia,then occlusion the mucosa.Results：All of 4 pigs were survived.1 was by way of creating submucosal tunnel;2 of by after total length cutting open;1 full-thickness perforation,after muscular occlusion by using Ti-clip,POEM was followed and accomplished.Conclusion：POEM is feasible.Although the risk of perforation、bleeding and so on is high,and further studies on long-term efficacy and on comparison of POEM with other interventional therapies are to be expected,it will be doing well if the complications are handled promptly.