臨牀消化器内科 Vol.25 No.8(3-1)


特集名 拡大内視鏡はどこまで必要か?
題名 胃の内視鏡 (1) 検診スクリーニングの立場から
発刊年月 2010年 07月
著者 安田 貢 香川県立がん検診センター消化器科
著者 河合 公三 香川県立中央病院消化器内科
【 要旨 】 胃内視鏡検診はX線に比較して診断精度が高い検査として認識されており,その受診者は急増中である.受診者は苦痛の少ない検査を望む傾向があるため,高画質の内視鏡機種は細径化の方向に進みつつあるし,さらに受容性に優れて安全な経鼻内視鏡検査を導入する検診施設が増えているのが現状である.一方,拡大内視鏡は病変の発見のみならず,質的診断や範囲診断,さらに胃癌危険度評価の可能性まで有する多機能機種であるが,現行のモデルでは外径が比較的太いため,鎮静薬を用いないかぎり,ルーチンの検診には選択されにくいものと思われる.
Theme Magnifying Endoscopy -- Is It Really Necessary for All the Endoscopists?
Title Stomach Cancer Screening and Magnifying Endoscopy
Author Mitsugi Yasuda Department of Gastroenterology, Kagawa Prefectural Cancer Detection Center
Author Kouzou Kawai Department of Gastroenterology and Hepatology, Kagawa Prefectural Central Hospital
[ Summary ] Endoscopic screening for gastric cancer is recognized as being more diagnostically accurate than X-ray screening. The number of individuals screened with this tool has increased markedly. Individuals being screened tend to prefer a less invasive procedure. Therefore, endoscopes with higher image quality are being produced with smaller diameters. Transnasal endoscopy is more readily accepted by individuals being screened and is safe in terms of less hemodynamic stress on the individual being screened. As a result, an increasing number of screening facilities are using this procedure. Additionally, magnifying endoscopes are exceptional, multi-purpose instruments which allow for the detection of lesions as well as qualitative assessment and determination of extent. These instruments also make it possible to assess the risk of gastric cancer. Because of these factors, new types of magnifying endoscopes have relatively large outer diameters, making them less appealing for use in routine screening without sedation.
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