Akahoshi Kazuya, Motomura Yasuaki, Kubokawa Masaru, Matsui Noriaki, Oda Manami, Okamoto Risa, Endo Shingo, Higuchi Naomi, Kashiwabara Yumi, Oya Masafumi, Akahane Hidefumi, Akiba Haruo
Department of Gastroenterology, Aso Iizuka Hospital, 3-83 Yoshio, Iizuka 820-8505, Japan.
World J Gastroenterol. 2009 May 7;15(17):2162-5. doi: 10.3748/wjg.15.2162.
Endoscopic submucosal dissection (ESD) with a knife is a technically demanding procedure associated with a high complication rate. The shortcomings of this method are the inability to fix the knife to the target lesion, and compression of the lesion. These can lead to major complications such as perforation and bleeding. To reduce the risk of complications related to ESD, we developed a new grasping type scissors forceps (GSF), which can grasp and incise the targeted tissue using electrosurgical current. Colonoscopy on a 55-year-old woman revealed a 10-mm rectal submucosal nodule. The histological diagnosis of the specimen obtained by biopsy was carcinoid tumor. Endoscopic ultrasonography demonstrated a hypoechoic solid tumor limited to the submucosa without lymph node involvement. It was safely and accurately resected without unexpected incision by ESD using a GSF. No delayed hemorrhage or perforation occurred. Histological examination confirmed the carcinoid tumor was completely excised with negative resection margin.
使用刀具进行内镜黏膜下剥离术（ESD）是一项技术要求高且并发症发生率高的手术。该方法的缺点是无法将刀具固定在目标病变上，以及对病变的压迫。这些可能导致诸如穿孔和出血等严重并发症。为降低与ESD相关的并发症风险，我们开发了一种新型抓持式剪刀钳（GSF），它可以利用电外科电流抓持并切割目标组织。对一名55岁女性进行结肠镜检查时发现一个10毫米的直肠黏膜下结节。活检获取标本的组织学诊断为类癌肿瘤。内镜超声显示一个低回声实性肿瘤，局限于黏膜下层，无淋巴结受累。使用GSF通过ESD安全、准确地切除了该肿瘤，未发生意外切割。未出现延迟性出血或穿孔。组织学检查证实类癌肿瘤被完全切除，切缘阴性。
