Theme |
Latest Developments in Devices Related to Colonoscopy and Progress in Insertion Techniques |
Title |
Magnifying Colonoscopy -- It's Actual Procedure |
Author |
Takahiro Fujii |
Department of Internal Medicine, National Cancer Center Hospital |
Author |
Yutaka Saito |
Department of Internal Medicine, National Cancer Center Hospital |
Author |
Takahiro Kozu |
Department of Internal Medicine, National Cancer Center Hospital |
Author |
Takahisa Matuda |
Department of Internal Medicine, National Cancer Center Hospital |
Author |
Kogi Fu |
Department of Internal Medicine, National Cancer Center Hospital East |
Author |
Yasushi Sano |
Department of Internal Medicine, National Cancer Center Hospital East |
Author |
Shigeharu Kato |
Kato Clinic |
[ Summary ] |
It is possible to routinely use the new magnifying colonoscope in colonoscopic examinations, because this scope allows ordinary views and, moreover, pro vides 100 percent magnification. It is generally being popularized by the CF-Q 240 ZI, in comparison to the CF-200 Z, because the CF-Q 240 ZI has improved the efficiency of insertion and quality of endoscopic imaging. The main role of magnifying diagnosis consists of two items, differential diagnosis of non-neoplasia and neoplasia, and diagnosis of depth of carcinomatous invasion. Because of this, we are using the modified Kudo's pit pattern classification with 6 types, it is roughly divided into 3 types (I II: non-neoplasia, IIIL IIIs IV : intramucosal neoplasia, V invasive cancer). As for diagnosis of depth of invasion, we individually evaluate each diagnosis with conventional and magnifying views. If the diagnosis is the same by both means, a treatment plan will be decided on, using colonoscopy with a magnifying view only. However, if there is a discrepancy between both types of diagnosis, superficial type colorectal cancer will be treated by using EUS for precise diagnosis. With small protruding cancers will try to remove them by using EMR, for precise diagnosis and treatment. |