| Theme |
Training System and Risk Management for Endoscopic Submucosal Dissection (ESD) |
| Title |
Peri-therapeutic Treatment and Advantage of General Anesthesia for Endoscopic Submucosal Dissection (ESD) Cases |
| Author |
Yoshitaka Sato |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Haruhiro Inoue |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Makoto Kaga |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Takemasa Hayashi |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Hitoshi Satodate |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Shin-ei Kudo |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| [ Summary ] |
Similar, positive views were held by all contributing to this report on ESD modalities. A antithrombotic drugs should be withdrawn preoperatively to decrease hemorrhagic risk. However, care should be taken to avoid thromboembolisms in the withdrawl period. Therefore, we find varied opinions by medical specialists concerning correct drug withdrawal periods. Sedation of the patient should be by intravenous injection of diazepam (5-10 mg / body) and pethidine hydrochloride (35 mg / body). However, it is difficult to maintain appropriate sedative states when ESD is performed over an extended period. Because of this, patients being operated on for over two hours should receive general anesthesia. General anesthesia was used in 92 ESD cases, from November, 2002 to March, 2006. There were no complications reported with patients receiving general anesthesia. There are many merits in using general anesthesia during ESD. The use of general anesthesia is considered safe even in ESD cases which are difficult. Intraoperative incidents seemed to decrease when ESD was performed using general anesthesia. |