インドシアニングリーン併用による半導体レーザー治療 A New Procedure of ICG Enhanced Diode Laser Therapy for Hemorrhoids

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痔核の新しい治療法として,インドシアニングリーン(ICG)を痔核内に注入し,低出力で半導体レーザーを照射する非観血的治療法が有用であることをすでに報告した.今回,術後の痛みなどについて105例に術後アンケート調査を行い,回答のあった89例(回答率84.8%)について,術後の疼痛を検討すると,結紮切除術に比べ痛みの訴えが少なかった.また,半導体レーザーを接触させて切開で使用する事により,3度までの内外痔核例に適応が可能である.しかし,粘膜脱には効果がない.本法は,痔核に対する簡便,安全かつ侵襲の少ない効果的な治療法である.

Indocyanine green (ICG) dye enhanced diode laser photosclerotherapy has been reported to be useful as a simple, safe and effective preventive treatment for bleeding from esophageal varices. I have applied this therapy to hemorrhoids as an alternative treatment. The injected ICG solution absorbs the diode laser beam effectively and coagulates the submucosal hemorrhoidal tissue selectively. The ICG dyed layer also prevents the laser beam from penetrating directly into the muscularis propriae and protects it from being damaged. A postoperative survey revealed that 92.9% (79/85 patients) of those who underwent this therapy were satisfied with their postoperative conditions. 23.5 % claim no postoperative pains in hospital (vs 5.9 % for ligation and excision procedure (LE)). 44.1% claim no pains with oral analgesic (vs 64.7% for LE). 26.5% complain of endurable pains with oral analgesic (vs 17.6 % for LE) . 5.9 % complain of unendurable pains with oral analgesic (vs 11.8% for LE). Compared to LE, this therapy results in fewer complaints of postoperative pains. The duration of the operation is 10.5 minutes on average, shorter than the 13.6 minutes on average for LE. It is concluded that ICG dye enhanced diode laser therapy is useful for the treatment of hemorrhoids.

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  • 日本大腸肛門病学会雑誌

    日本大腸肛門病学会雑誌 56(10), 815-818, 2003-10-01

    The Japan Society of Coloproctology

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