| 特集名 | EUSによる診断と治療 -- 現状と将来展望 | |
|---|---|---|
| 題名 | 米国におけるinterventional EUSの現状と研究動向 | |
| 発刊年月 | 2005年 10月 | |
| 著者 | 深見 悟生 | Department of Gastrointestinal Medicine and Nutrition, The University of Texas M.D. Anderson Cancer Center |
| 【 要旨 】 | 超音波内視鏡は画像診断法から組織採取 (fine needle aspiration) を可能にした診断手技となり，その可能性を拡げてきた．組織採取も消化管粘膜下腫瘍，膵胆管腫瘍，消化管周囲リンパ節からさらに適応拡大されてきている．米国では組織診断率と合併症率から超音波内視鏡下の手技が膵癌の組織採取では第一選択となっている．治療手技として超音波ガイド下針穿刺が治療薬物注入に応用されるようになり，治療としての適応も拡大されている．今後の超音波内視鏡は針穿刺によるさまざまな注入療法など，基礎から臨床への応用研究を取り入れながらより発展していくであろう． | |
| Theme | Present Status and Future Aspects of EUS | |
|---|---|---|
| Title | Current Status and Future Direction of Interventional EUS in the United States | |
| Author | Norio Fukami | Department of Gastrointestinal Medicine and Nutrition, The University of Texas M.D. Anderson Cancer Center |
| [ Summary ] | Endoscopic ultrasonography emerged as an innovative imaging modality years ago. Its capabilities were expanded with the invention of curvilinear array echoendoscope, which has the ability for tissue acquisition with fine-needle aspiration (EUS-FNA). The indications for the EUS-FNA are rapidly expanding from submucosal tumors, pancreatobiliary neoplasms and surrounding lymph nodes to a wide variety of adjacent organs and tumors outside the gastrointestinal tract. The complications of EUS-FNA were reviewed and the complication rate was considered to be similar to that with other imaging guided FNA. Currently, EUS-FNA is the preferred method for tissue acquisition from pancreas tumors in the U.S. EUS-guided cholangiopancreatography with subsequent internal drainage has been described in cases with failed endoscopic retrograde cholangiopancreatography and in some cases with challenging anatomy. Applying the same technique of FNA, innovative drug delivery with fine needle injection (FNI) has been studied. EUS-FNI is an attractive technique to deliver various therapeutic agents directly into approachable tissues and tumors. Ongoing clinical and translational researches will assist making further progress in the clinical use of EUS-FNA and FNI. |
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