Mori Hirohito, Rahman Asadur, Kobara Hideki, Fujihara Shintaro, Nishiyama Noriko, Ayaki Maki, Matsunaga Tae, Murakami Masanori, Masaki Tsumomu
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Takamatsu, Japan.
Digestion. 2017;95(1):6-15. doi: 10.1159/000452352. Epub 2017 Jan 5.
Endoscopic full-thickness resection (EFTR) is a procedure that makes it possible to access the lesions that are on the wall of the digestive tract via the shortest distance through the mouth. Because of the ultra-minimal invasive nature of the treatment, pure EFTR is a highly promising surgical procedure that allows the radical excision of full-thickness layers of digestive tract tumors using only a flexible endoscope. There are 2 types of EFTR methods: exposed and non-exposed. Considering the risks of contracting infection and intraperitoneal dissemination of tumor cells, non-exposed EFTR is an ideal method. However, a number of issues remain unresolved, including the method for performing a full-thickness suture under endoscopic view and the challenge of securing the operating field in the case of gastrointestinal tract collapse. Moreover, advances in the development of equipment such as full-thickness suturing devices would be helpful to make this therapeutic procedure the most minimally invasive endoscopic surgery ever.
内镜全层切除术（EFTR）是一种能够通过经口最短路径到达消化道壁上病变部位的手术。由于该治疗具有超微创的特性，单纯EFTR是一种极具前景的外科手术，它仅使用一根柔性内镜就能对消化道肿瘤的全层进行根治性切除。EFTR方法有两种：暴露式和非暴露式。考虑到感染风险以及肿瘤细胞的腹腔内播散，非暴露式EFTR是一种理想的方法。然而，仍有一些问题尚未解决，包括在内镜视野下进行全层缝合的方法以及在胃肠道塌陷情况下确保手术视野的挑战。此外，诸如全层缝合装置等设备的开发进展将有助于使这种治疗方法成为有史以来创伤最小的内镜手术。
