| 효과적인 내시경 점막하 박리술을 위한 고무밴드와 클립을 이용한 견인법의 유용성 |
| 이보인ㆍ김병욱ㆍ최황ㆍ지정선ㆍ정우철ㆍ이강문ㆍ이인석ㆍ김진일ㆍ최명규ㆍ최규용ㆍ정인식ㆍ맹이소* |
| 가톨릭대학교 의과대학 내과학교실, *병원병리학교실 |
| Traction with using a Rubber Band and Clips for Effective Endoscopic Submucosal Dissection |
| Bo-In Lee, M.D., Byung-Wook Kim, M.D., Hwang Choi, M.D., Jeong-Seon Ji, M.D., Woo-Chul Chung, M.D., Kang-Moon Lee, M.D., In-Seok Lee, M.D., Jin-Il Kim, M.D., Myung-Gyu Choi, M.D., Kyu-Yong Choi, M.D., In-Sik Chung, M.D. and Lee-So Maeng, M.D.* |
| Departments of Internal Medicine and *Hospital Pathology, College of Medicine, The Catholic University of Korea, Incheon, Korea |
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| Abstract |
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Background/Aims:
Traction with using a rubber band and clips may be helpful for performing endoscopic submucosal dissection (ESD) by keeping adequate tissue tension and satisfactory submucosal exposure.
Methods:
17 patients with noninvasive neoplasias or intramucosal cancers (16 gastric lesions and 1 colonic lesion) were included to evaluate this technique's feasibility (3), because of a difficult location for dissection (11), unsatisfactory mucosal elevation despite adequate submucosal injection (2), and a high risk of perforation from the thin colonic wall (1). Submucosal dissection was performed after traction was applied, with a using a rubber band and clips, to a precut margin of the lesion.
Results:
The mean sizes of the 16 gastric neoplasias and the corresponding resected specimens were 16±9 mm (6∼40) and 37±9 mm (18∼50), respectively, and the sizes of the colonic intramucosal cancers and the resected specimens were 41 mm and 51 mm), respectively. Both the en-bloc resection rate and the complete resection rate were 77%. Complete ESD without snaring was preformed in 10 cases (59%). The traction was assessed as useful in eleven cases (65%), not useful in two (12%), and annoying in four (23%).
Conclusions:
Traction with using a rubber band and clips can be useful for performing ESD. (Korean J Gastrointest Endosc 2008;36:341-348) |
| Key Words:
Endoscopic submucosal dissection, Traction, Complication, Gastric neoplasms, Colorectal neoplasms |
| 주요어:
내시경 점막하 박리술, 견인, 합병증, 위종양, 대장종양 |
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