CAJ | 학술논문

目的探讨经自然腔道内镜腹腔探查术经胃、经结肠、经脐3种入路可行性,并评价单纯经自然孔道内镜腹腔探查术和复合经自然孔道内镜腹腔探查术优缺点.方法选取2头家猪分别行单纯经自然孔道内镜腹腔探查术与复合经自然孔道内镜腹腔探查术.每头猪均行经胃、经结肠、经脐3种入路进行腹腔探杳,记录并对比每种入路检查完成情况、术中反应及操作难易程度.术后尸解观察腹腔脏器损伤及造口闭合程度.结果 2头猪术中生命体征均稳定,术后尸解均末见造口周围脏器损伤.经胃探查与经结肠探查均存在一定盲区,且闭合胃壁造口难于闭合结肠造口,经脐探查与腹腔镜技术相似.在安全造口、稳定气腹、充分探查方面,复合经自然孔道内镜腹腔探查术优于单纯经自然孔道内镜腹腔探查术.结论经自然孔道内镜腹腔探查术中经胃、经结肠、经脐3种入路在技术上均具有可行性,且复合自然孔道内镜腹腔探查术优于单纯自然孔道内镜腹腔探查术.
목적 탐토경자연강도내경복강탐사술경위、경결장、경제3충입로가행성,병평개단순경자연공도내경복강탐사술화복합경자연공도내경복강탐사술우결점.방법 선취2두가저분별행단순경자연공도내경복강탐사술여복합경자연공도내경복강탐사술.매두저균행경위、경결장、경제3충입로진행복강탐묘,기록병대비매충입로검사완성정황、술중반응급조작난역정도.술후시해관찰복강장기손상급조구폐합정도.결과 2두저술중생명체정균은정,술후시해균말견조구주위장기손상.경위탐사여경결장탐사균존재일정맹구,차폐합위벽조구난우폐합결장조구,경제탐사여복강경기술상사.재안전조구、은정기복、충분탐사방면,복합경자연공도내경복강탐사술우우단순경자연공도내경복강탐사술.결론 경자연공도내경복강탐사술중경위、경결장、경제3충입로재기술상균구유가행성,차복합자연공도내경복강탐사술우우단순자연공도내경복강탐사술.
Objective To evaluate the feasibility,advantages and pitfalls of trans gastric,trans colonic and trans umbilical peritoneoscopy,and to compare pure natural orifice transluminal endoscopic surgery (NOTES) with hybrid NOTES.Methods Two female pigs of 30 kg were used in the study:one for pure NOTES,and one for hybrid NOTES.Each pig received trans gastric,trans colonic and trans umbilical peritoneoseopy,respectively,followed by postmortem examination for organic lesions and closure of incisions.The two approaches were compared in terms of intra-operative situation and manipulation.Results The vital signs of the pigs were stable during the procedures,with no peri-incision organic lesions.There were blind areas in trans gastric as well as in trans colonic peritoneoscopy.It was easier to close the colonic incision than the gastric one.The situation in trans umbilical peritoneoscopy was similar to laparoscopic surgery.Hybrid NOTES seemed superior to pure NOTES with regard to safe access,stable pneumo peritoneum and adequate visualization.Conclusion Three routes for NOTES appear to be reasonable and feasible.Hybrid NOTES is more effective and safer than pure NOTES with current instruments.