| 特集名 | 大腸ESD | |
|---|---|---|
| 題名 | 大腸ESDのコツとピットフォール ; 胃と大腸の違いを含めて (6) ITナイフ，Bナイフ -- CO2送気も含めて | |
| 発刊年月 | 2006年 11月 | |
| 著者 | 斎藤 豊 | 国立がんセンター中央病院内視鏡部 |
| 著者 | 菊地 剛 | 国立がんセンター中央病院内視鏡部 |
| 著者 | 松田 尚久 | 国立がんセンター中央病院内視鏡部 |
| 著者 | 池原 久朝 | 国立がんセンター中央病院内視鏡部 |
| 著者 | 浦岡 俊夫 | 国立がんセンター中央病院内視鏡部 |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | Colorectal endoscopic submucosal dissection | |
|---|---|---|
| Title | Techniques for and challenges with colorectal ESD -- using IT knife with CO2 insufflation | |
| Author | Yutaka Saito | Division of Endoscopy, National Cancer Center Hospital |
| Author | Tsuyoshi Kikuchi | Division of Endoscopy, National Cancer Center Hospital |
| Author | Takahisa Matsuda | Division of Endoscopy, National Cancer Center Hospital |
| Author | Hisatomo Ikehara | Division of Endoscopy, National Cancer Center Hospital |
| Author | Toshio Uraoka | Division of Endoscopy, National Cancer Center Hospital |
| [ Summary ] | Endoscopic submucosal dissection (ESD) is accepted as a minimally invasive treatment for early gastric cancer. However, it is not widely used in the colorectum because of technical difficulties. ESDs were generally performed based on the indication for endoscopic treatment established at NCCH primarily for non-granular type laterally spreading tumors (LST-NGs) > 20 mm. Procedures were performed using an insulation-tipped knife (IT knife) or a bipolar needle knife (B-knife) with carbon dioxide (CO2) insufflation. After injection of glycerol and sodium hyaluronate acid into the submucosal layer, a circumferential incision was made and a submucosal dissecfion was performed endoscopically. The B-knife results in safer ESD because the electronic current is localized at the needle tip. The IT knife also decreases the risk of colonic perforation due to the insulated tip being attached to the end of the needle. The combined use of these two instruments enables us to perform colorectal ESDs safely and easily. CO2 insufflation, which has been proven safe and effective during colorectal ESD, has been used recently at NCCH. ESD is a feasible technique for treating large superficial colorectal tumors because it provides a higher en-bloc resection rate and is less invasive than surgical resection. |
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