| 特集名 | EMR vs. ESD | |
|---|---|---|
| 題名 | 側方断端陽性とならない胃癌内視鏡治療 | |
| 発刊年月 | 2008年 01月 | |
| 著者 | 本間 清明 | 山形県立日本海病院消化器科／北庄内内視鏡研究会 |
| 著者 | 名木野 匡 | 山形県立日本海病院消化器科／北庄内内視鏡研究会 |
| 著者 | 早坂 高志 | 市立酒田病院消化器科／北庄内内視鏡研究会 |
| 著者 | 今泉 和臣 | 市立酒田病院消化器科／北庄内内視鏡研究会 |
| 著者 | 松本 祐治 | 健友会本間病院外科／北庄内内視鏡研究会 |
| 著者 | 本間 清和 | 酒田地区医師会会長／北庄内内視鏡研究会 |
| 【 要旨 】 | 内視鏡的粘膜下層剥離術 (ESD) は，大型病変の一括切除とともに意図したラインを切離できる手技として有効性は大きい．しかし，難易度の高い技術を要する手技であることが問題の一つであった．筆者らは，スネア先端にカッティングナイフを備えたK snareを開発した．粘膜切開・緊縛をこれのみを用いて操作し，高い一括切除率を維持しながら小・中型病変のESDを簡略化しえた．ESDの普及は，難病変をセンター化することや，頻度の多い病変に対する治療成績のよい簡略化した手法を適応することなどによって，効果と効率を両立した新しい胃癌内視鏡治療へ発展するものと考えた． | |
| Theme | Therapeutic Strategy for Early Gastrointestinal Cancers with EMR or ESD | |
|---|---|---|
| Title | Efficient Techniques for en bloc Resection of Gastric Tumors | |
| Author | Kiyoaki Homma | Gastroenterology, Yamagata Prefectural Nihonkai Hospital / Endoscopy Study Group in the Northern Part of Shonai |
| Author | Kou Nagino | Gastroenterology, Yamagata Prefectural Nihonkai Hospital / Endoscopy Study Group in the Northern Part of Shonai |
| Author | Takashi Hayasaka | Deartment of Gastroenterology, Municipal Sakata Hospital / Endoscopy Study Group in the Northern Part of Shonai |
| Author | Kazuomi Imaizumi | Deartment of Gastroenterology, Municipal Sakata Hospital / Endoscopy Study Group in the Northern Part of Shonai |
| Author | Yuji Matsumoto | Deartment of Surgery, Honma Hospital / Endoscopy Study Group in the Northern Part of Shonai |
| Author | Kiyokazu Homma | Sakata Medical Association/ Endoscopy Study Group in the Northern Part of Shonai |
| [ Summary ] | Endoscopic submucosal resection (ESD) has made it possible to resect large tumors en bloc on the exact line intentionally and to perform detailed pathologic examinations. However, ESD requires more skill than EMR in order to manipulate endoscopes and forceps. While gastric tumors with diameters of less than 30 mm, and which were in antrum and angle were frequently seen in endoscopic resections. If these tumors could be resected easily and certainly, the level of treatments would improve. K snare with a cutting knife on top has been developed. This tool has made it easy to perform ESD on gastric tumors with diameters less than 30 mm. It is necessary for efficient treatments of gastric tumors to center patients and to resect frequent tumors by easy and certain methods within the limits of human resources and time available. K snare will be used more freguently for ESD of gastric tumors. |
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