| 特集名 | 大腸EMR，ESDの進歩 | |
|---|---|---|
| 題名 | 治療機器の工夫・改良 (3) CO2送気装置 | |
| 発刊年月 | 2007年 11月 | |
| 著者 | 菊地 剛 | 国立がんセンター中央病院内視鏡部 |
| 著者 | 斎藤 豊 | 国立がんセンター中央病院内視鏡部 |
| 著者 | 松田 尚久 | 国立がんセンター中央病院内視鏡部 |
| 著者 | 浦岡 俊夫 | 岡山大学大学院医歯薬学総合研究科肝臓・消化器・感染症内科学 |
| 著者 | 中島 健 | 国立がんセンター中央病院内視鏡部 |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | Endoscopic treatment of early colorectal cancer and adenoma -- the advancement of EMR and ESD technique | |
|---|---|---|
| Title | CO2 delivery system | |
| Author | Tsuyoshi Kikuchi | Division of Endoscopy, National Cancer Center Hospital |
| Author | Yutaka Saito | Division of Endoscopy, National Cancer Center Hospital |
| Author | Takahisa Matsuda | Division of Endoscopy, National Cancer Center Hospital |
| Author | Toshio Uraoka | Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences |
| Author | Takeshi Nakajima | Division of Endoscopy, National Cancer Center Hospital |
| [ Summary ] | Endoscopic submucosal dissection (ESD) is a useful method for enabling en-bloc resection of large laterally spreading tumors. These tumors are usually treated with piecemeal resection (EPMR). However, this procedure requires a great deal of time in some cases, when a considerable amount of air is insufflated into the colonic lumen, causing severe intraoperative and postoperative abdominal discomfort. Compared to air, carbon dioxide (CO2) is reabsorbed more easily in the intestinal tract. The safety and efficacy of CO2 insufflation during colonoscopy has been reported in some trials. However, there has been no trial concerning the safety of CO2 insufflation during long duration ESD procedurs under conscious sedation. It was observed that there are no complications when using insufflation. Moreover, this procedure is effective in reducing abdominal discomfort, as shown in a pilot study. Thus, since November 2004 CO2 insufflation has been used routinely to decrease abdominal discomfort during colonic ESD. More than 200 procedures have been conducted in this facility. In this study transcutaneous carbon dioxide (PtcCO2) was monitored in 37 cases using PtcCO2 non-invasive sensors placed on the earlobe with a dedicated ear clip. PtcCO2 values did not increase to levels which would cause CO2 narcosis, proving that CO2 insufflation is safe for colonic ESD. |
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