Fujishiro Mitsuhiro, Kodashima Shinya, Goto Osamu, Ono Satoshi, Muraki Yosuke, Kakushima Naomi, Omata Masao
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Surg Laparosc Endosc Percutan Tech. 2008 Dec;18(6):592-7. doi: 10.1097/SLE.0b013e318187973f.
Endoscopic submucosal dissection (ESD) permits the resection of large gastrointestinal epithelial neoplasms and neoplasms with submucosal fibrosis in an en bloc manner. However, the high frequency of complications accompanying ESD and its complex processes suggests that the process requires improvement. A total of 22 consecutive patients with gastrointestinal epithelial neoplasms were enrolled during a 6-month period to evaluate a novel endosurgical knife for ESD. This novel knife is known as the "splash-needle," and it is thin, short needle with a water-irrigation function. The technical results revealed that the rates of bloc resection and en bloc resection with tumor-free lateral/basal margins (R0 resection) were 91% (20/22) and 82% (18/22), respectively. There was no significant bleeding or perforation during or after ESD. The median operation time was 60 minutes (range, 20 to 210). The splash-needle is a promising novel endosurgical knife that is useful for less complicated ESD. The accumulation of knowledge and cases verifying its usefulness is necessary, and a study comparing the knife with first-generation endosurgical knives is also warranted.
内镜黏膜下剥离术（ESD）能够整块切除大型胃肠道上皮性肿瘤以及伴有黏膜下纤维化的肿瘤。然而，ESD伴随的高并发症发生率及其复杂的操作过程表明该手术方式仍需改进。在6个月的时间里，共纳入了22例连续性胃肠道上皮性肿瘤患者，以评估一种用于ESD的新型内镜手术刀。这种新型手术刀被称为“飞溅针”，它是一种带有水冲洗功能的细短针。技术结果显示，整块切除率以及切缘无肿瘤的整块切除率（R0切除）分别为91%（20/22）和82%（18/22）。ESD术中及术后均未出现明显出血或穿孔。中位手术时间为60分钟（范围为20至210分钟）。飞溅针是一种很有前景的新型内镜手术刀，适用于操作不太复杂的ESD。有必要积累知识和病例以证实其有效性，同时也有必要开展一项将该手术刀与第一代内镜手术刀进行比较的研究。
