ABSTRACT
Background: Currently, many problems are still controversial on performing out of digestive tract operation through endoscopic submucosal tunnel. Aims: To evaluate the feasibility and safety of endoscopic mediastinal exploration via esophageal submucosal tunnel. Methods: Endoscopic mediastinal exploration was performed via esophageal submucosal tunnel in two healthy swine. A 5 cm submucosal tunnel was created with blunt dissection. The mucosal incision was closed by hemostatic clips, and penicillin was used prophylactically. Two weeks later, after reexamined by gastroscopy, the animals were sacrificed and the esophagus was obtained for macropathology and histopathology. The survival rate, wound healing and complications were observed. Results: The mediastinal organs such as aorta, trachea, and pericardium were identified clearly during exploration. All the animals survived with no obvious complications. Gastroscopy and histopathology showed good wound healing two weeks after operation. Taking autopsy as standard, the anatomical structures were accurately identified under endoscopy. Conclusions: Animal experiment revealed that mediastinal exploration via transesophageal endoscopic submucosal tunnel is feasible and relatively safe.