Hochberger J, Kruse E, Köhler P, Bürrig K-F, Menke D
Medizinische Klinik III, Schwerpunkt Allgemeine Innere Medizin, Gastroenterologie, Interventionelle Endoskopie, St.-Bernward-Krankenhaus, Akad. Lehrkrankenhaus der Universität Göttingen, Treibestrasse 9, 31134, Hildesheim, Deutschland.
HNO. 2009 Dec;57(12):1237-52. doi: 10.1007/s00106-009-2022-0.
In the past 10 years endoscopic diagnostics has benefited from technologies such as big chips, high-definition television (HDTV) and narrow band imaging (NBI). Video capsule endoscopy and double balloon enteroscopy have facilitated visualization of the entire small bowel. A number of studies on mucosal Barrett's and gastric cancers could prove that endoscopic mucosal resection (EMR) is oncologically equivalent to surgical resection when certain criteria are respected. However, EMR is less invasive and carries a substantially lower complication risk and mortality compared to surgery. Endoscopic submucosal dissection (ESD) facilitates en bloc resection with thorough histopathologic evaluation of the specimen, e.g. for mucosal lesions in the stomach and rectum. Endosonography (EUS) guided transgastric necrosectomy using a flexible gastroscope has set a milestone in the treatment of infected pancreatic necroses and has replaced open surgery in many centers. Natural orifice transluminal endoscopic surgery (NOTES) uses natural body openings as minimally invasive access to the abdomen and mediastinum. Interventional GI endoscopists and minimally invasive surgeons have profited from these innovations in micromechanics and microelectronics.
在过去10年中，内镜诊断技术受益于大芯片、高清电视（HDTV）和窄带成像（NBI）等技术。视频胶囊内镜和双气囊小肠镜有助于观察整个小肠。多项关于巴雷特食管黏膜和胃癌的研究表明，当遵循一定标准时，内镜黏膜切除术（EMR）在肿瘤学上等同于手术切除。然而，与手术相比，EMR的侵入性较小，并发症风险和死亡率也显著降低。内镜黏膜下剥离术（ESD）有助于整块切除标本，并对其进行全面的组织病理学评估，例如用于胃和直肠的黏膜病变。使用柔性胃镜进行的超声内镜（EUS）引导下经胃坏死组织切除术在感染性胰腺坏死的治疗方面树立了一个里程碑，并且在许多中心已取代了开放手术。经自然腔道内镜手术（NOTES）利用人体自然开口作为进入腹部和纵隔的微创通道。介入性胃肠内镜医师和微创外科医生已从这些微机械和微电子学创新中受益。
