Research Of Important Esophageal Submucosal Tunnel Technology In Expanding Diagnosis And Treatment Of The Technology

Background and Objective:Because per-oral Endoscopic submucosal tunneling technology have advantages of preventing perforation and closing mucosal incision easily, especially esophageal adjacent structures are closest to the esophagus, the technology must achieve the desired effect in curing the diseases of esophageal adjacent structures. Firstly in our animal experiment study we establish safe passage from the esophagus to mediastinum in porcine models, this animal study was performed to evaluate the feasibility and safety of endoscopic trans-esophageal biopsy by using submucosal tunneling technology in the posterior mediastinum. Exploration of necessary conditions will be done to establish a basis for the theory and practice in the clinical diagnosis and treatment of esophageal andt mediastinal disease; To find sensitive indicators associated with pneumothorax pneumothorax by animal experiments.Methods:①The procedure was performed on six healthy domestic pigs on left sides under general anesthesia. An 6 mm video endoscope was introduced into the esophagus, a 10-cm submucosal tunnel was developed with blunt dissection. The mediastinal compartment, lung, the descending thoracic aorta, and exterior surface of the esophagus were identified. Mediastinal living tissue biopsy was accomplished. ②After the establishment of transesophageal endoscopic surgical mediastinal tunnel model,18 pigs were randomly divided into 3 groups:free pressure(A group>10mmHg), low pressure control group(group B<4mmHg) and high-pressure-control group (group C<8mmHg),made a baseline 10min before operation, when 10 minutes,20 minutes and 30 minutes monitoring physiology, respiratory mechanics and hemodynamics, which will becompared between groups③mking 6 CO2 pigs models of thoracentesis pneumothorax a,monitoring physiology, respiratory mechanics and hemodynamics; made a baseline 10min before operation, monitoring physiology, respiratory mechanics and hemodynamic changes of three pneumothoraxs.Results: ②The procedure was successfully completed in all six pigs. Mediastinal structures could be identified without difficulty by the transesophageal tunneling approach. Tissue as lymph nodes and pleural biopsy under direct visualization were easily accomplished. Two pig died after operation due to pneumothorax.② A group:PH CI、ITBI and OI increases, HR、 MAP、PaC02 and PRaw rises, which have significant difference statistically, these data of B group have no significant difference statistically and these data of C group have significant difference statistically pneumothorax had been observed in all pigs of A group, two dead due to acute pneumothorax ③By establishing pneumothorax model of C02 we study physiological respiratory mechanics and hemodynamic changes. The models were successfully completed in all six pigs. Increased mean airway pressure、HR and induced OI and PH were discovered on a little left pneumothorax, but have no significant difference statistically; apparent Increased mean airway pressure、HR、PaC02 and induced Oximetry were discovered on Moderate, and severe left pneumothorax, which have significant difference statistically.Conclusion:Firstly in our animal experiment study we establish safe passage from the esophagus to mediastinum in porcine models, this animal study was performed to evaluate the feasibility and safety of endoscopic transesophageal biopsy by using submucosal tunneling technology in the posterior mediastinum.When now conditions, transesophageal mediastinal operation is still difficult, and pressure monitoring is carried out to ensure operation safe; Monitoring physiological respiratory mechanics and hemodynamic changes was necessary,which can provide warning signals of complications. These data will be well signal of pneumothorax.