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EndoTODAY ³»½Ã°æ ±³½Ç


[APC (argon plasma coagulation)]


1. APC for gastric neoplasm

°æºÏ´ëÇб³ Àü¼º¿ì ±³¼ö´Ô ÆÀ¿¡¼­ À§¾Ï/¼±Á¾¿¡ ´ëÇÑ APC Ä¡·á ¼ºÀûÀ» ¹ßÇ¥ÇÏ¿´½À´Ï´Ù (Kim. Clin Endosc 2015).


2. ´ëÀå EMR + APC ÈÄ visible vesselÀÇ Àå½Ã°£ °üÂû

Digestive Diseases & Sciences 2015³â 10¿ùÈ£¿¡¼­ ¼øõÇâ´ëÇб³ õ¾Èº´¿ø Á¤À챂 ±³¼ö´ÔÀÇ Èï¹Ì·Î¿î ¿¬±¸¸¦ º¸¾Ò½À´Ï´Ù (Jung Y. Dis Dis Sci 2015). ´ëÀå ³»½Ã°æ µµÁß EMR + prophylatic APC ÈÄ º´¼Ò¸¦ 1ºÐ, 3ºÐ, 5ºÐ, 7ºÐ¿¡ °üÂûÇÏ¿´½À´Ï´Ù. óÀ½¿¡´Â º¸ÀÌÁö ¾Ê´ø visible vesselÀÌ Á¡Â÷ °üÂûµÇ¾ú½À´Ï´Ù. ÀúÀÚµéÀº EMR + prophylatic APC ÈÄ ¸î ºÐ°£ °üÂûÇÏ¿© õõÈ÷ µå·¯³ª´Â visible vessel¿¡ ´ëÇÏ¿© Ãß°¡ Ä¡·á¸¦ ÇØ ÁÖ¸é Áö¿¬ÃâÇ÷ÀÌ ÁÙ¾îµé °ÍÀ̶ó°í ¾ð±ÞÇÏ¿´½À´Ï´Ù.

An immediate assessment of iatrogenic ulcers after EMR may not be the best way to prevent delayed PPB if some of the damaged or prominent vessels hidden by the submucosal injection delay bleeding. The damaged or prominent vessels with a potential risk of delayed bleeding can be hidden by the submucosal injection...

Endoscopists should observe selected patients for sufficient time, such as those who underwent a difficult colonoscopy, those with poor performance status, and those at high risk for delayed bleeding.

In conclusion, large ([1 cm) post-polypectomy ulcers were related to the occurrence of visible vessels in ulcers after colonic EMR. A 5-min period of observation of an iatrogenic ulcer after EMR with prophylactic APC may help identify these visible vessels.

Submucosal injection¿¡ ÀÇÇÏ¿© °¨Ãß¾îÁø Ç÷°üÀÌ ¸î ºÐ ÈÄ µå·¯³¯ ¼ö ÀÖÀ¸¹Ç·Î °íÀ§Çè º´¼Ò¿¡¼­´Â Ä¡·áºÎÀ§¸¦ 5ºÐ Á¤µµ °üÂûÇÏ´Â °ÍÀÌ ÁÁ°Ú´Ù´Â Á¦¾ÈÀÔ´Ï´Ù. ÁÁÀº ¿¬±¸¶ó°í »ý°¢ÇÕ´Ï´Ù. ±×·±µ¥ ¿ì¸®¿¡°Ô ÀÌ·¸°Ô ¿À·¡ ±â´Ù¸± ½Ã°£ÀÌ ÀÖÀ»±î¿ä?

ÈǸ¢ÇÑ ¿¬±¸ ÃàÇϵ帳´Ï´Ù.

© ÀÏ¿ø³»½Ã°æ±³½Ç ¹Ù¸¥³»½Ã°æ¿¬±¸¼Ò ÀÌÁØÇà. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng.