• Title/Summary/Keyword: 내시경 점막하 절개술

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Clinical Availability of Endoscopic Incision and Submucosal Dissection for the Treatment of Gastric Neoplasms (위종양성 병변에 대한 내시경 절개 점막하 박리법의 임상적 유용성)

  • Jung, Yoon-Ho;Eun, Soo-Hoon;Cho, Joo-Young;Jung, In-Seop;Ryu, Chang-Beom;Lee, Joon-Seong;Lee, Moon-Sung;Kim, Boo-Sung;Shim, Chan-Sup
    • Journal of Gastric Cancer
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    • v.6 no.2
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    • pp.76-83
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    • 2006
  • Purpose: Endoscopic incision and submucosal dissection (EISD) is a technique that is being implemented for the resection of gastric adenomas and early gastric cancer (EGC). Since EISD requires a high degree of skill and experience, and due to its association with a moderate risk of gastrointestinal bleeding, its use has been limited. The objective of this study is to investigate the clinical benefits of EISD based upon clinical data on the EISD procedure. Materials and Methods: This study was conducted at Soonchunhyang University Hospital and it included 179 gastric adenoma and early gastric carcinoma lesions from 164 patients who had undergone an EISD from February 2003 to May 2005. Results: Among the total of 179 lesions, the distributions of EGC and adenomas were 70.3% (126/179) and 23.4% (42/179) respectively. The sizes of lesions were divided into 10 mm or less, $11{\sim}20\;mm,\;21{\sim}30\;mm$ and greater than 31 mm and each rates are 10.0% (18/179), 46.3% (83/179), 30% (50/179) and 15.0% (28/179). Among 120 cases which could be measured depth of lesion in according to pathologic findings, m1 (0.8%, 1/120), m2 (38.3%, 46/120), m3 (25%, 57/120), sm1 (11.7%, 14/120), sm2 (1.6%, 2/120) were diagnosed as early stages of gastric cancer. The complete resection rate was 85.2% (150/176) and en-bloc resection rate was 96.0% (169/176). Complications as such as perforation and bleeding developed in 4.4%(8/179) and 21.2% (38/179), respectively. Conclusion: EISD is an effective in the endoscopic treatment for gastric adenoma and early gastric cancers. However, further evaluation of this method and long-term follow-up will be necessary for an evaluation of the recurrence rate after resection of a tumor.

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Characterization of Porcine Tissue Perforation Using High-Power Near-Infrared Laser at 808-nm Wavelength (808 nm 파장의 고출력 근적외선 레이저 조사 시 돼지 조직의 천공 특성 연구)

  • Kim, Seongjun;Cho, Jiyong;Choi, Jaesoon;Lee, Don Haeng;Kim, Jung Kyung
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.37 no.9
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    • pp.807-814
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    • 2013
  • A fundamental study on laser-tissue interaction was conducted with the aim of developing a therapeutic medical device that can remove lesions on the intestinal wall by irradiating a high-power 808-nm infrared laser light incorporated in an endoscopic system. The perforation depth was linearly increased in the range of 1~4 mm in proportional to laser output (3~12 W) and irradiation time (5~20 s). We demonstrated that the perforation depth during laser irradiation was varied according to the tissue property of each extracted porcine organ. The measurement of the temperature distribution suggests that the energy is localized in the irradiation spot and transferred to deep tissue, which protects the surrounding tissue from thermal injury. These results can be used to set the driving parameters for a laser incision technique as an alternative to conventional surgical interventions.