磁性水凝胶黏膜下注射辅助离体猪食管内镜黏膜下剥离术的可行性研究

Feasibility study of submucosal injection of magnetic hydrogel to assist esophageal endoscopic submucosal dissection

目的探讨基于磁锚定技术的磁性水凝胶辅助内镜黏膜下剥离术(ESD)的可行性。方法以新鲜离体猪食管为模型,在黏膜下注射自行配置的海藻酸钠-四氧化三铁微粒溶液和交联剂,使两者发生反应形成磁性水凝胶。在食管外放置锚定磁体后,黏膜下的磁性水凝胶被吸引,连同病变黏膜一起被抬起,可辅助完成ESD。结果在锚定磁体的磁场力作用下,磁性水凝胶被锚定磁体吸引,可充分显露黏膜剥离面术野并形成足够的组织张力,改善术者操作体验,提高整块黏膜切除率。结论黏膜下注射磁性水凝胶在食管ESD中具有可行性,后续将进一步优化磁性水凝胶性能并进行验证。该技术有望应用于临床。

Objective To investigate the feasibility of magnetic hydrogel based on magnetic anchor technique in the application of assisted endoscopic mucosal dissection.Methods Using fresh pig esophagus as model,the magnetic hydrogel was formed by submucosal injection of self-configured sodium alginate ferric oxide microparticle solution and crosslinking agent.After the anchor magnet was placed outside the esophagus,the submucosal magnetic hydrogel was attracted and the diseased mucosa was lifted to assist the completion of endoscopic submucosal dissection.Results Under the magnetic force of the anchor magnet,the magnetic hydrogel is attracted by the anchor magnet,which can fully expose the mucosal dissection field,form sufficient tissue tension,improve the operator's operation experience and the resection rate of the whole mucosa.Conclusion Magnetic hydrogel submucosal injection is feasible in esophageal endoscopic submucosal dissection and further optimizes the performance of magnetic hydrogel,this technique is expected to be used clinically.