Watahiki Yu, Kawashima Kazumasa, Hikichi Takuto, Takagi Tadayuki, Onizawa Michio, Gunji Naohiko, Watanabe Chiharu, Wada Jun, Oka Yuka, Hashimoto Yuko, Ohira Hiromasa
Department of Gastroenterology Fukushima Medical University School of Medicine Fukushima Japan.
Department of Endoscopy Fukushima Medical University Hospital Fukushima Japan.
DEN Open. 2023 Jun 15;4(1):e259. doi: 10.1002/deo2.259. eCollection 2024 Apr.
Balloon-assisted endoscopy enables stable endoscopic maneuverability. Balloon-assisted endoscopic submucosal dissection (BA-ESD) is useful in the treatment of proximal colorectal tumors where scope maneuverability is poor. Herein, we reported a case in which BA-ESD was successfully performed using a long colonoscope with a guidewire, although the lesion could not be reached using the balloon-assisted endoscopy technique with a therapeutic colonoscopy. A 50-year-old man underwent a colonoscopy that revealed a tumor in the ascending colon. BA-ESD was performed using a conventional therapeutic endoscope due to excessive intestinal elongation and poor endoscopic maneuverability. However, the transverse colon loop could not be reduced, and the total colonoscopy failed despite using balloon-assisted endoscopy. The scope was then changed from a conventional colonoscope to a long colonoscope, inserted into the terminal ileum, and the loop was reduced. After the guidewire was placed at the terminal ileum and the long colonoscope was removed, a therapeutic colonoscopy with an overtube was inserted into the ascending colon without reforming the colonic loop, allowing safe BA-ESD.
气囊辅助内镜检查可实现稳定的内镜操作。气囊辅助内镜黏膜下剥离术（BA-ESD）在治疗近端结直肠肿瘤时很有用，因为这些部位的内镜操作难度较大。在此，我们报告了一例病例，尽管使用治疗性结肠镜的气囊辅助内镜技术无法到达病变部位，但使用带导丝的长结肠镜成功进行了BA-ESD。一名50岁男性接受结肠镜检查，发现升结肠有肿瘤。由于肠道过度延长和内镜操作困难，使用传统治疗性内镜进行了BA-ESD。然而，横结肠袢无法复位，尽管使用了气囊辅助内镜检查，全结肠镜检查仍失败。然后将内镜从传统结肠镜更换为长结肠镜，插入回肠末端，使袢复位。在回肠末端放置导丝并移除长结肠镜后，在不重新形成结肠袢的情况下，将带外套管的治疗性结肠镜插入升结肠，从而安全地进行了BA-ESD。
