The Study Of Endoscopic Submucosal Pre-dissection Injection And Wound Healing With The Absorbable Himostat Textile

Part One Study on the Absorbable Hemostat textile injection in endoscopic submucosal dissection(ESD)Aim:The aims of this study were to evaluate the effect of Absorbable Hemostat textile submucosal injection and verify the application value of this treatment procedure.Methods:In the uplift experiment,the experimental group used Absorbable Hemostat textile solution,the control group used glycerol fructose,normal saline,simulated ESD surgeries were performed in vivo rabbit stomach.The uplift effect was measured at Omin,10min,20min,30min.The injection site was pathological examined at 30 minutes after the injection,postoperative ulcers bleeding were recorded.In vivo bleeding amount measurement experiment,endoscopic submucosal dissection(ESD)surgery simulation were performed in the rabbit stomachs.A 1ml syringe with 0.1m1 lmwh was used to suction the blood on the ulcers,until the bleeding stopped,and the amount(ml)of postoperative bleeding was recorded.A SPSS16.0 software for one-way ANOVA,P<0.05,the difference was significant between the experimental group and the control group.Pre clinical trials,all colorectal ESDs were performed by one endoscopist.Twelve pigs(about 2 months,weight 10±1.5kg)were under general anesthesia,select the ESD operation area(20cm---30cm from the anus),back mirror,front mounted on the transparent cap,in order to ensure the conformation of the endoscopic wounds size,open the biopsy forcep catching a round yellow paper(1.5cm in diameter)to the operation area,before ESD operations,submucosal injections were Absorbable Hemostat textile and saline solution.The differences between the two groups were endoscopic examed at 3 days,1 week,2 weeks after the ESD operations.Results:1.In the effect of uplift experiment,the experimental group with better rising height and longer last time than the control group(P<0.05,the experimental group the amount of bleeding was significantly lower than the control group(P<0.05);glycerol fructose was significantly lower than the normal saline group(P<0.05).2.In the preclinical experiment,the experimental group and the control group,a total of 24 cases of ulcers and injection areas,no hemorrhage,perforations and other experiments related adverse events.Conclusions:Our animal study experimentally demonstrated that Absorbable Hemostat textile were of high value in uplift application in endoscopic submucosal dissection(ESD).Part Two Study on the application of Absorbable Hemostat textile shielding on ulcers induced by endoscopic submucosal dissectionAim:The aims of this study were to evaluate the healing process of ESD-induced ulcers in animals shielding with a Absorbable Hemostat textile sheet,and verify the application value of this treatment procedure.Methods:In vivo bleeding amount measurement experiment,endoscopic submucosal dissection(ESD)surgery were performed in the rabbit stomachs.A 1ml syringe with 0.1ml lmwh was used to suction the blood on the ulcers in 30min,and the amount(ml)of postoperative bleeding was recorded.A SPSS16.0 software for t test,the difference was significant between the experimental group and the control group(P<0.05).Pre clinical experiments:All colorectal ESDs were performed by one endoscopist with twelve pigs(about 2 months,weight 10±1.5kg)under general anesthesia,select the endoscopic submucosal dissection(ESD)operation area(20cm---30cm from the anus),open the biopsy forcep catching a yellow round paper 1.5cm in diameter to the operation area,marker dots were made by IT knife along the edge of the yellow round pape.At last,two same size endoscopic submucosal dissection(ESD)ulcers were made.Every pig underwent 2 endoscopic submucosal dissection(ESD)operation with 15mm diameter size,then the experimental group was shielded with Absorbable Hemostat textile,the control group was left undone.Endoscopic examed at 3 days,1 weeks,2 weeks,4 weeks after the endoscopic submucosal dissection(ESD)operation,Pathological examinations were underwent at 1 week,2 weeks,4 weeks after the endoscopic submucosal dissection(ESD)operation,The operation time of shielding the sheet was recorded.Results:1.In the rabbits experiments,The amount of bleeding in the experimental group was significantly lower than that in the control group(P<0.05).2.In the Pre clinical experiments,no procedure-related adverse event occurred.Pre clinical trials,there is no obvious adverse events in the experiment group.Conclusions:Our study experimentally demonstrated that this treatment technique is simple,safe and of high application value in ESD-induced ulcers.