啄木鸟刀在内镜黏膜下剥离术中的应用

目的探讨运用啄木鸟刀在消化道内镜黏膜下剥离(ESD)术中治疗病变的临床价值和安全性。方法回顾性分析2017年5月-2018年3月内镜下使用啄木鸟刀治疗消化道黏膜病变患者36例,部分联合热止血钳电凝血管,观察病变切除率、手术时间、术中出血、术后并发症发生情况及手术器械更换频率。结果 36例患者均成功完成ESD治疗,手术时间15.0～62.0 min,平均39.8 min,手术成功率100%,术中12例大血管内镜下电凝成功,无出血。所有患者创面均未出现迟发性出血或穿孔。结论 ESD术中应用啄木鸟刀辅助能缩短手术时间,降低术中大血管出血的发生,在术中是安全有效的附件。手术器械更换频率降低,减少手术风险,从而能够高质量、高效率的完成手术。

Application of woodpecker knife in endoscopic mucosal dissection

Abstract: Objective To explore the clinical value and safety of endoscopic woodpecker knife in treatment of lesions in endoscopic mucosal stripping of digestive tract. Methods Retrospective analysis of May 2017 to March 2018 endoscopic one-time mucosa knife treatment of digestive tract mucosa lesions in 36 cases of patients, part of the joint hot hemostatic forceps electric coagulation of blood vessels, observe the lesion resection rate, operation time, intraoperative bleeding, postoperative complications and surgical instruments replacement frequency. Results All the 36 patients successfully completed ESD treatment, with an average operation time of 39.8min (15.0 ~ 62.0 min), a 100% success rate, 12 cases of intraoperative large vessels, successful electrocoagulation under endoscopy, and no bleeding. All the patients had no delayed bleeding or perforation. Conclusion The use of woodpecker knife in ESD surgery can shorten the operation time, reduce the occurrence of intraoperative large blood vessel bleeding. It''s a safe and effective accessory in the operation. The frequency of surgical instrument replacement and the operation risk is reduced, the operation is completed with high quality and efficiency.