• 제목/요약/키워드: Endoscopic

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Salvage Endoscopic Resection for Residual Lesion after Definitive Chemoradiotherapy in Esophageal Cancer

  • Kim, Seong Jung;Hong, Ran;Lee, Jun
    • Journal of Digestive Cancer Reports
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    • 제7권2호
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    • pp.57-60
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    • 2019
  • Definitive chemoradiotherapy (CRT) with its significant efficacy and safety in esophageal cancer is reserved for patients with unresectable tumor or those who decline surgery. However, the incidence of locoregional failure or recurrence after definitive CRT remains high. Although esophagectomy is the standard treatment for locoregional failure or recurrence, this approach is associated with high mortality and morbidity. A 56-year-old man diagnosed with esophageal squamous cell carcinoma who refused to undergo surgery received definitive CRT. An endoscopy for response assessment performed after 2 months revealed a residual lesion, which was completely resected by salvage endoscopic submucosal dissection. To the best of our knowledge, endoscopic resection in locoregional failure or recurrence after definitive CRT is very rarely reported, and there are no guidelines or consensus to date. Here, we report a case of successful salvage endoscopic resection of residual lesion after definitive CRT.

위의 인환세포암(Signet Ring Cell Carcinoma)에서 내시경적 절제술: 가능성과 한계점 (Possibility and Limitation of Endoscopic Treatment in Early Gastric Signet Ring Cell Carcinoma)

  • 강선형;정현용
    • Journal of Digestive Cancer Research
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    • 제6권2호
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    • pp.55-58
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    • 2018
  • Gastric signet ring cell carcinoma (SRC) is a poorly differentiated or undifferentiated cancer of the stomach. However, early gastric SRC showed lower LN metastasis in many studies, thus some endoscopists now regard early gastric SRC as a candidate for endoscopic treatment. But there are unsolved problems of the validity of endoscopic resection in early gastric SRC. In this review, we will comprehensively review the previous clinical studies and discuss the limitation of current studies and the possibility of endoscopic resection of early gastric SRC.

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십이지장 팽대부 종양의 내시경적 치료 (Endoscopic Management of Ampullary Tumors)

  • 정회훈;박재근
    • Journal of Digestive Cancer Research
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    • 제11권2호
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    • pp.93-98
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    • 2023
  • Ampullary tumor is a rare disease whose prevalence rate has increased gradually in recent years with the increase in endoscopic examinations. Ampullary lesions are observed via endoscopy, and biopsy is done to determine whether such lesions are adenomas or carcinomas. Endoscopic papillectomy is performed on ampullary adenomas without intraductal lesions. Before the procedure, bleeding tendencies and pancreatitis are assessed, and the lesion is resected using a high-frequency wave and a thin wire snare. Thereafter, pancreatic duct stent insertion or clipping of the resection site is performed to prevent postprocedural pancreatitis. Although 47-93% of the patients achieve complete endoscopic papillary resection, the recurrence rate is 5-31%. Hence, regular follow-up via endoscopy is required.

Optimal endoscopic drainage strategy for unresectable malignant hilar biliary obstruction

  • Itaru Naitoh;Tadahisa Inoue
    • Clinical Endoscopy
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    • 제56권2호
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    • pp.135-142
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    • 2023
  • Endoscopic biliary drainage strategies for managing unresectable malignant hilar biliary obstruction differ in terms of stent type, drainage area, and deployment method. However, the optimal endoscopic drainage strategy remains unclear. Uncovered self-expandable metal stents (SEMS) are the preferred type because of their higher functional success rate, longer time to recurrent biliary obstruction (RBO), and fewer cases of reintervention than plastic stents (PS). Other PS subtypes and covered SEMS, which feature a longer time to RBO than PS, can be removed during reintervention for RBO. Bilateral SEMS placement is associated with a longer time to RBO and a longer survival time than unilateral SEMS placement. Unilateral drainage is acceptable if a drainage volume of greater than 50% of the total liver volume can be achieved. In terms of deployment method, no differences were observed in clinical outcomes between side-by-side (SBS) and stent-in-stent deployment. Simultaneous SBS boasts a shorter procedure time and higher technical success rate than sequential SBS. This review of previous studies aimed to clarify the optimal endoscopic biliary drainage strategy for unresectable malignant hilar biliary obstruction.

내시경을 이용한 겨드랑절개 이중평면 유방확대술 (Endoscopic Transaxillary Dual Plane Breast Augmentation)

  • 심형보;위형곤;홍윤기
    • Archives of Plastic Surgery
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    • 제35권5호
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    • pp.545-552
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    • 2008
  • Purpose: The transaxillary approach for breast augmentation has been advocated for patients and surgeons for several decades. However, this blind technique had many disadvantages including, traumatic dissection, difficult hemostasis, displacement of implants, and ill-defined asymmetrical location of inframammary crease. In the present study, the precise endoscopic electrocautery dissection was applied to eliminate the limits of blunt dissection throughout the procedures. Methods: From December 2006 to December 2007, a total of 103 patients with an average age of 29.5 years underwent endoscopic assisted transaxillary dual plane augmentation mammoplasty. The mean implant size was 243 cc with the range between 150 and 350 cc. Through a 4 cm axillary incision, electrocautery dissection for submuscular pockets was carried out under the endoscopic control. The costal origin of pectoralis muscle was completely divided to expose subcutaneous tissue and to make type I dual plane. Results: Using the endoscopic dissection, we achieved good aesthetic results including a short recovery period, less morbidity, and symmetrical well-defined inframammary crease. Type I dual plane procedure could support the consistent inframammary fold shape and be applied to most patients without breast ptosis. Minor complications did not occur, however, four major complications of capsular contracture occurred. Conclusion: In contrast to the era of the blind techniques, endoscopic assisted transaxillary dual plane breast augmentation can now be performed effectively and reproducibly. With Its advantage, the axillary application of endoscopy for augmentation mammaplasty is useful to achieve the optimal cosmetic outcomes.

Endoscopic Management of Cranial Arachnoid Cysts Using Extra-Channel Method

  • Kim, Myung-Hyun;Jho, Hae-Dong
    • Journal of Korean Neurosurgical Society
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    • 제47권6호
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    • pp.433-436
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    • 2010
  • Objective : Arachnoid cysts (ACs) can be cured by making the definite and wide communication between the cyst and arachnoid space using endoscopy, but often it is impossible only through the usual working-channel (intra-channel) procedures. We discuss and propose a more valuable endoscopic technique with the presentation of our series of cases. Methods : We treated 9 patients with cortical AC in various locations with extra-channel endoscopic techniques. The patients ranged in age from 3 years to 60 years (mean age, 37.2 yrs). The follow-up period ranged from 12 to 26 months (mean follow-up duration, 17.2 months). All patients had large AC compressing the adjacent brain with clinical symptoms or signs. The authors performed extensive fenestration via single burr hole with the aid of endoscope. Being bypassed the rigid endoscope, through the space between the shaft of endoscope and guiding cannula (extra-channel method), fenestration procedures were done in the dry fields. Results : Eight (88.9%) patients had been treated successfully with endoscope. One patient required shunt procedure. Among the eight patients who were treated with endoscopic procedure, 6 patients (66.7%) showed cyst reduction, and two (22.2%) showed disappearance of cyst. Conclusion : We suggest that extra-channel method will be simple and easy to perform using more valuable instruments with wider working area, and may promise better results compared to the conventional intra-channel endoscopic procedures.

3D 내시경 영상처리를 위한 다중화기 설계와 부호화 성능평가 (Evaluation of Coding Performance and Design of Spatial Multiplexer or 3D Endoscopic Image Processing)

  • 송철규;이상민;이영묵;김원기;황종대;김정훈;이명호
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1997년도 추계학술대회
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    • pp.137-141
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    • 1997
  • In this study, in order to improve visualization and enhance the ability of the surgeon to perform delicate endoscopic surgery, three dimensional endoscopic system is designed. These 3D systems have our features of stereoendoscopic image processing: real time image capture and retrieve; presentation of left and right image on a single monitor; separable processing of the left and right eye images; coding of the 3D endoscopic video. For 3D endoscopic video coding, three approaches are presented based on interlaced picture structure, side-field format structure, and simulcast technique. Experimental results and performances comparisons are presented and analyzed or these approaches. Digital video coding techniques are presented or 3D endoscopic video sequences by means of an MPEG-2 video coding.

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아래턱뼈 관절돌기밑 골절에서 내시경을 이용한 관혈적 정복술 및 내부고정술의 임상적 적용 (Clinical Applications of Endoscopic-Assisted Open Reduction and Internal Fixation of Subcondylar Fractures)

  • 한승열;강석주;박진형
    • Archives of Plastic Surgery
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    • 제36권6호
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    • pp.735-742
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    • 2009
  • Purpose: The management of fractures of mandibular subcondyle continues to be controversial between open and closed treatment. The purpose of this article is to explain the endoscopic assisted open reduction and internal fixation and minimize the controversy. Methods: Nine patients of mandibular subcondylar fracture were reduced and fixed by using intraoral endoscopic - assisted open reduction and internal fixation and were followed up for 14 ~ 24 months after surgery. Results: Eight patients of mandibular subcondylar fracture had been treated without significant complications. One patient, whose malocclusion had been remained, was recovered normal occlusion by maxillomandibular fixation using intermaxillary screws for 3 weeks. Conclusion: The advantages of endoscopic - assisted open reduction and internal fixation are direct visualization, accurate fracture repair, minimized scar, decreased morbidity. And maxillomandibular fixation is not needed when it is done by accurate reduction and rigid fixation with one miniplate in the region of subcondylar fracture. With the above consideration, endoscopic - assisted open reduction and internal fixation can be considered as one of the best treament for subcondylar fracture of the mandible.

비내누낭비강문합술에서 Mitomycin-C의 효과 (Mitomycin-C in Endoscopic Dacryocystorhinostomy)

  • 김명원;이종환;김은석;이상철;장백암;변영자
    • 대한기관식도과학회지
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    • 제4권2호
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    • pp.188-192
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    • 1998
  • Background and Objectives: The most common cause of the failure of endoscopic dacryocystorhinostomy is closure of the osteotomy site due to granulation or adhesion. We used mitomycin-C, an antineoplastic antibiotic agent, soaking over the osteotomy site to suppress fibrous proliferation and scar formation during the endoscopic dacryocystorhinostomy. Materials and Methods : A total of 20 Patients diagnosed with nasolacrimal duct obstruction were assigned randomly to either a mitomycin-C group or a control group. Endoscopic dacryocystochinostnmy has been used in both groups. In the mitomycin-C group, a piece of merocel soaked with 0.2 mg/ml mitomycin-C was applied to the osteotomy site and then after 30 minutes was removed. Results : All patients in the mitomycin-C group remained symptom free after removal of their silicone tube (100% success), and there were two patients in the control group who had recurrent epiphora (67% success). In the mitomycin-C group, the average surface area of the osteotomy at the end of the sixth postoperative month was 4.1 $\textrm{mm}^2$, whereas that of the control group was 2.5 $\textrm{mm}^2$. Neither serious systemic nor local toxicity were noted in the mitomycin-C group. Conclusion : Intraoperative mitomycin-C may possibly improve success rates over the endoscopic dacryocystorhinostomy procedure.

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Endoscopic Resection of Xanthogranulomatous Gastritis Presenting as a Subepithelial Tumor: A Case Report

  • Kim, Tae Wan;Kim, Tae Ho;Kim, Chang Whan;Chang, Jae Hyuck;Han, Sok Won;Kim, Jae Kwang
    • 대한상부위장관⦁헬리코박터학회지
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    • 제18권3호
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    • pp.198-203
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    • 2018
  • Xanthogranulomatous gastritis (XGG) presenting as a subepithelial tumor (SET) is a very rare entity. We report a case of SET-like XGG diagnosed and treated with endoscopic resection. A 55-year-old female patient was initially referred with a 1.5-cm SET located at the anterior wall of the middle antrum. Endoscopic ultrasound examination revealed submucosal invasion without any perigastric lymph node enlargement. Endoscopic resection was performed for an accurate diagnosis and treatment, and the lesion was diagnosed histopathologically as XGG. At the 18-month follow-up after endoscopic resection, there was no evidence of XGG recurrence. SET-like XGG is very rare and the diagnosis is a preoperative challenge. However, inflammatory tumors should be considered in the differential diagnosis of SET.