Digestive organ endoscopic treatment
The polyp which endoscopic treatment needs
Early cancer and adenoma which has not yet cancerated become a target of the treatment. The advanced cancer is out of adaptation. Endoscopic treatment is a possibility or judges even an early cancer after size exceeding 2-3cm, and at first performing pathology organization inspection (overhaul) as (the thing that shintatsudo of cancer infiltrated the mucous membrane lower layer than medium degree) and the thing with the metastasis to lymphatic gland may become out of adaptation. The treatment is the future.
Treatment technique
poripekutomi: It is a method to be performed for an upheaval type lesion mainly. After using the wire of the oval called the snare in the base of the polyp, and having tightened it, I remove it surgically by a high-frequency current.
A mucous membrane resection: The flatness that it is difficult to hang a snare directly or the polyp which sank is adaptation. At first a local site injects a saline under the lesion endoscopically and lets the whole lesion rise including the outskirts and therefore I hang a snare and send an electric current by a high-frequency current and remove it surgically. As they can remove it surgically widely from poripekutomi, an early cancer and the polyp which is more likely to cancerate become the adaptation. There is not the pain after excision, and the walk is possible, too.
ESD
With ESD "art of endoscopic mucous membrane lower layer detachment is an abbreviation of Endoscopic Submucosal Dissection".
The esophagus and stomach, the wall of the large intestine are made from the mucous membrane layer, the mucous membrane lower layer, three layers called the muscular layer, but cancer exfoliates the mucous membrane lower layer who included the class of mucous membranes with a gastrocamera and a large intestine camera for an earlier lesion in a cancer from a gastrointestinal lumen in an early stage to occur from the class of mucous membranes which are the inside layer and is a cure to remove a lesion surgically collectively.
It is published insurance in stomach earliest from 2006 and becomes performed as the insurance treatment that a country admitted in large intestine in the esophagus next from 2011 in 2008 normally now.
I removed it surgically in the circle called the snare called EMR (endoscopic mucous membrane incision: endoscopic mucosal resection), but a cancer remained without being able to evaluate the progress degree of correct cancer because a limit was to the size that I could remove surgically (told to be usually to 2cm in the stomach) and was often removed surgically separately and invited a recurrence till then by keeping the lesion which must originally operate more intact.
The cure that overcame a weak point of EMR is ESD. The technique that tore off a mucous membrane with various knives thinly was studied and was able to remove even a big lesion surgically by a lump. In our House ESD I gain good results.
The esophagus and stomach, the wall of the large intestine are made from the mucous membrane layer, the mucous membrane lower layer, three layers called the muscular layer, but cancer exfoliates the mucous membrane lower layer who included the class of mucous membranes with a gastrocamera and a large intestine camera for an earlier lesion in a cancer from a gastrointestinal lumen in an early stage to occur from the class of mucous membranes which are the inside layer and is a cure to remove a lesion surgically collectively.
It is published insurance in stomach earliest from 2006 and becomes performed as the insurance treatment that a country admitted in large intestine in the esophagus next from 2011 in 2008 normally now.
I removed it surgically in the circle called the snare called EMR (endoscopic mucous membrane incision: endoscopic mucosal resection), but a cancer remained without being able to evaluate the progress degree of correct cancer because a limit was to the size that I could remove surgically (told to be usually to 2cm in the stomach) and was often removed surgically separately and invited a recurrence till then by keeping the lesion which must originally operate more intact.
The cure that overcame a weak point of EMR is ESD. The technique that tore off a mucous membrane with various knives thinly was studied and was able to remove even a big lesion surgically by a lump. In our House ESD I gain good results.
About an accidental occurrence symptom
Bleeding and perforation (there being a hole in perforation = gastrointestinal tract) are thought about. As for the outbreak frequency, 1% of bleeding is said to the perforation with 0.05-0.1% (than the national statistics report of the Japanese endoscope society).
As the prevention
1) Sew up an excision stump by a clip endoscopically.
2) Internal use and the intravenous feeding of the styptic.
3) Give a diet cure for enteral rest.
In addition, I may need a surgical management (open surgery) by degree when it bores it. In addition, please talk as it is necessary for the person that a thrombolytic drug (panarujin, aspirin, warfarin) is taken in other Houses to cancel it beforehand.
As the prevention
1) Sew up an excision stump by a clip endoscopically.
2) Internal use and the intravenous feeding of the styptic.
3) Give a diet cure for enteral rest.
In addition, I may need a surgical management (open surgery) by degree when it bores it. In addition, please talk as it is necessary for the person that a thrombolytic drug (panarujin, aspirin, warfarin) is taken in other Houses to cancel it beforehand.
Length of stay
I judge it by a number and the form of tumor recently as a delayed-action bleeding and perforation example of 3-5 days is reported to ESD which should be one-day treatment (evening of the day discharge) other than ESD after excision. It is the hospitalization within 5-7 days basically. In addition, the treated one, please note that it is fast by fluid food or a condition for intestinal tract rest as for the meal of the day.