FIBERGASTROSCOPIC POLYPECTOMY WITH SNARE METHOD AND ITS SIGNIFI CANCE DEVELOPED IN OUR DEPARTMENT:-POLYP RESECTION AND RECOVERY INSTRUMENTS

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概要

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• The endoscopic daignosis of the intra-gastric polyps can be performed almost correctly unless any cancerous lesion should be hidden where biopsy forceps have no access. At this stage it cannot be denied that all the polyps are not affected with cancer, however, the partial resection of benign polyps in the stomach has been considered as the most recommendable method for a fibergastroscopic treatment, and for this reason we have developed the method and instrument to cut and recover intra-gastric polyps under endoscopic observation which we have named "Polypectomy", and it has two ways, namely, Method I and Method II. Polypectomy Method I: A double folded stainless-steel wire which is inserted with an outer-tube into the stomach through the biopsy forceps channel of a fibergastroscope forms a loop to hook and cut the polyp with a squeezing motion of the looped wire. Then the resected polyp is collected with the biopsy forceps afterwards. Polypectomy Method II: In this method a pair of scissors are equipped at the tip of the outer-tube and a loop line is made of twisted fine wires, and the loop can be easily formed in a circle with a single action, which enables the cutting and collection of the polyp in one and short period of time. In these methods, 43 polyps in 39 cases have been resected with a very slight bleeding at their roots, and such an artificial ulcer can be healed within two weeks generally. Besides, the overall histological classification of the resected 24 polyps is: 23 adenomatous polyps (including 4 cases of polyp with atypical epithelium) and one aberrant pancreas. The recovery rate of the resected polyps has been better in method II and the present average is 74 per cent. In conclusion, those methods have the following advantages:(1) An easy and safe method to treat intragastric polyps instead of a surgical treatment.(2) The periodical observation of the cases, patients' anxiety, and unnecessary laparotomy can entirely be avoided.(3) The overall histrogical examination of the polyps becomes possible as contrasted with the conventional partial biopsy.

• 社団法人 日本消化器内視鏡学会の論文

著者

• 内田 隆也

  日本医科大学第3内科

• 常岡 健二

  日本医科大学

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