Authors: Daniel von Renteln Melina C Vassiliou Karel Caca Arthur Schmidt Richard I Rothstein
Publish Date: 2010/12/07
Volume: 25, Issue: 7, Pages: 2350-2357
Abstract
Secure access and reliable closure is paramount in the setting of transesophageal mediastinal endoscopic surgery The purpose of this study was to develop a secure transesophageal access technique and to evaluate the feasibility safety and efficacy of a novel covered selfexpanding retractable stent for closure of 15mm esophageal defectsFifteenmillimeter esophagotomies were created in 18 domestic pigs using needle knife puncture and balloon dilatation or a blunt dissection technique Six animals were randomly assigned to open surgical repair and six animals to endoscopic closure using a selfexpanding covered nitinol stent Danis SXELLA stent ELLACS in a nonsurvival setting Pressurized leak tests were performed on all closures Six animals underwent transesophageal endoscopic mediastinal interventions and survived for 17 days Stents were extracted at day 10Nonsurvival experiments revealed two bleeding complications associated with the needle–knife access technique while bluntdissection mediastinal access was not associated with any complications Leak test results were not different for stent compared to surgical closures All survival animals were found to have complete closure and adequate healing of the esophagotomies No leakage or infectious complication occurredDaniel von Renteln Melina C Vassiliou Karel Caca and Arthur Schmidt have no conflicts of interest or financial ties relevant to this report to disclose Richard I Rothstein is a consultant for Ethicon EndoSurgery Inc Endotherapeutic material stents and endoscopic instruments for this study was provided by EllaCS and Ethicon EndoSurgery free of charge
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