ENDOSCOPIC SUBMUCOSAL DISSECTION FOR EARLY GASTRIC CANCER

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  • 胃におけるESD

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Abstract

Endoscopic submucosal dissection (ESD) allows en-bloc resection for a large lesion . It has a maximal advantage for obtaining an accurate histological diagnosis, although the procedure takes longer and requires grate technical skill, and cardiorespiratory risk is high if too much sedative is administered during ESD procedure. We let you do maneuver itself of ESD with distress more without can preserve quiescent of the patient in insufficient sedation . ESD should to be performed under general anesthesia in the operating room when the procedure is esti mated to take more than two hours. General anesthesia with intra tracheal intubation makes ESD easy and safe to perform. The development of various devices and high-frequency units is supporting this new endoscopic treatment. Some types of devices for cutting (eg . the IT knife) have appeared on the market ; it is essential to understand their electrosurgical charac teristics before using these devices. Accessory devices for hemorrhage and other items are effective for resolving difficult situations and complications. In the same way, to used highfrequency units for ESD safety, we need to understand their mechanism and characteristics, though there is no established theory for ESD.

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