Methods: Animal ethics committee approval was obtained. A single operator with extensive porcine and human EMR
experience performed oesophageal single-band mucosectomy (Cook MBL-6) on adult Raf inhibitor pigs. Resections were randomized in a balanced fashion to MCC (ERBE VIO 300D EndoCutQ) or LPFC (ERBE 100C 25W). Clear fluid and low residue diet was instituted 24 and 48 hours post MBM, respectively. Feeding and mobility behaviour was recorded daily. Necropsy was performed 72 hours post MBM. Two expert histopathologists blinded to the ESC technique evaluated the depth of tissue involvement in relation to: ulceration, necrosis, acute inflammation (presence of neutrophils), chronic inflammation (lymphocytes and plasma cells) Maraviroc molecular weight and fibroblastic reaction. Results: 156 tissue sections and 45 resection defects in 12 pigs were analyzed (24 LPFC, 21 MCC). All pigs survived to necropsy and tolerated an upgraded diet. The histopathological correlates corrected for submucosal thickness are shown in Table 1. Conclusions: In an experimental porcine model of a single band oesophageal mucosectomy the severity of deep mural injury as evidenced by ulceration and necrosis
of the muscle layer was significantly greater with LPFC than MCC. This suggests that LPFC use is more likely to result in stricture development than MCC. If both modalities offer equivalent efficacy and procedural safety for MBM of oesophageal neoplastic tissue, MCC would be preferable due to decreased depth and severity of tissue injury. Table 1: Histopathological correlates of MCC and LPFC. MCC (n = 21) LPFC (n = 24) P value Resection defect surface area (mm2) 222 256 0.4 Ulceration involving muscularis 1/21 (4.8%) 9/24 (37.5%) 0.04 Necrosis involving muscularis 1/21 (4.8%) 13/24 (54.2%) 0.001 Acute inflammation involving muscularis & adventitia 19/24 (79.2%) 24/24 (100%) 0.16 Fibroblastic reaction involving muscularis and adventitia 4/21 (19.0%) 4/24 (16.7%) 0.6 Muscularis propria injury / microscopic MCE公司 perforation 0/21 (0%) 1/24 (4.2%) 0.8 FF BAHIN,1,5 M JAYANNA,1 LF HOURIGAN,2 RV
LORD,3 DC WHITEMAN,4 SJ WILLIAMS,1 EY LEE,1 M SONG,1 R SONSON,1 MJ BOURKE1,5 1Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, NSW, 2Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, 3Department of Surgery, St Vincent’s Hospital, Sydney, NSW, 4Queensland Institute of Medical Research Berghofer, Brisbane, QLD, 5University of Sydney, NSW Background: Complete endoscopic resection (CER) of Barrett’s esophagus (BO) with high-grade dysplasia (HGD) and early oesophageal adenocarcinoma (EOA) is a precise staging tool, detects covert synchronous disease, and may produce a sustained treatment response. There is limited data on long-term outcomes in regards to dysplasia eradication and tolerability of CER.