臨牀消化器内科 Vol.25 No.8(5-1)


特集名 拡大内視鏡はどこまで必要か?
題名 大腸内視鏡 (1) 第一線(臨床現場)での内視鏡検査のありかた
発刊年月 2010年 07月
著者 尾田 恭 尾田胃腸内科
【 要旨 】 内視鏡診療は,個人開設の小規模医療機関においても高いレベルを提供できる数少ない医療分野であるが,開業医レベルでの拡大内視鏡導入の割合は1%以下と低い.それは,目指す内視鏡診療の内容による拡大内視鏡の必要性の違いとともに,拡大内視鏡の挿入性,組織診断への理解,拡大観察技術習得の必要性などの問題があろう.筆者は,開業医の立場であるが,内視鏡検査の苦痛の不安を取り除くのみでなく,拡大内視鏡やNBI(Narrow Band Imaging)システムを用いたより精度の高い診断,診療を患者とともに共有することで,内視鏡専門クリニックとして患者の信頼を得たいと考えている.その立場で,第一線の臨床現場で拡大内視鏡をどのように使用しているか提示する.
Theme Magnifying Endoscopy -- Is It Really Necessary for All the Endoscopists?
Title Usefulness of Magnifying Endoscopy for Colorectal Cancer Screening in Private Clinics
Author Yasushi Oda Oda GI Endoscopy and Gastroenterology Clinic
[ Summary ] Endoscopic practice is one of the few fields in which a solo private practice doctor may provide high level patient care as well as in high volume hospitals. However, the implementation of endoscopy with magnification in private clinics is very rare, accounting for less than 1% of cases. One reason would be the differences in contents of endoscopy practice that each doctoraims for. Anotherr eason is the level of difficulty in manipulating the tools, including insertion with minimal pain and comprehension of histology and interpretation of magnified images obtained with endoscopy. We would obtain patientsʼ confidence by sharing high quality magnified images and those obtained with Narrow Band Imaging even in a private practice. Techniques for presenting information obtained from high quality images of lesions to patients in a clinic are presented.
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