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EndoTODAY ³»½Ã°æ ±³½Ç


[¼øõ¸¸³»½Ã°æ¼¼¹Ì³ª] - ðû

1) Á¦1ȸ ¼øõ¸¸³»½Ã°æ¼¼¹Ì³ª (2013) - ÀÌÁØÇà °­ÀÇ: Gastric dysplasia

2) Á¦2ȸ ¼øõ¸¸³»½Ã°æ¼¼¹Ì³ª (2014) - ÀÌÁØÇà °­ÀÇ: ESD ½Ã´ëÀÇ Áø´Ü³»½Ã°æ

3) Á¦3ȸ ¼øõ¸¸³»½Ã°æ¼¼¹Ì³ª (2015) - ÀÌÁØÇà °­ÀÇ: °í·É ȯÀÚÀÇ ³»½Ã°æ

4) Á¦4ȸ ¼øõ¸¸³»½Ã°æ¼¼¹Ì³ª (2016) - ÀÌÁØÇà °­ÀÇ: ³»½Ã°æ ±â±¸ °ü¸®

5) Á¦5ȸ ¼øõ¸¸³»½Ã°æ¼¼¹Ì³ª (2017) - ÀÌÁØÇà °­ÀÇ: À§¼±Á¾

6) Á¦6ȸ ¼øõ¸¸³»½Ã°æ¼¼¹Ì³ª (2018) - ÀÌÁØÇà °­ÀÇ: À§½ÄµµÁ¢ÇÕºÎÀÇ ¾ç¼º ¹× ¾Ç¼º Áúȯ

7) Á¦7ȸ ¼øõ¸¸³»½Ã°æ¼¼¹Ì³ª (2019)

8) Á¦8ȸ ¼øõ¸¸³»½Ã°æ¼¼¹Ì³ª (2020) - ÀÌÁØÇà °­ÀÇ: À§Àå°ü °Ô½ÇÁõ (Covid-19 pandemic ¶§¹®¿¡ µ¿¿µ»ó °­ÀÇ·Î ÁøÇàÇÏ¿´½À´Ï´Ù.)


9) Á¦9ȸ ¼øõ¸¸³»½Ã°æ¼¼¹Ì³ª (2021)

On-line°ú off-line hybrid·Î ¼¼¹Ì³ª°¡ ÁøÇàµÇ¾ú½À´Ï´Ù.

Zoom È­¸é screenshot

¼­Á¾¿Á ¼±»ý´Ô²²¼­ ÇöÀå ½ºÄÉÄ¡¸¦ ÆäÀ̽ººÏ¿¡ ¿Ã¸®¼Ì½À´Ï´Ù.

ÈǸ¢ÇÑ ±³¼ö´ÔµéÀÇ ¸ÚÁø °­ÀÇ°¡ ÀÖ¾ú½À´Ï´Ù. ÀÌÁØÇà ¸Þ¸ð

Àú´Â ÀÜÀ§¾Ï¿¡ ´ëÇÏ¿© °­ÀǸ¦ ÇÏ¿´½À´Ï´Ù. °­ÀÇ µ¿¿µ»óÀ» º¸³Â°í ZoomÀ¸·Î ½Ç½Ã°£ Åä·ÐÀ» ÇÏ¿´½À´Ï´Ù.

ÀÌÁØÇà comment: ÃÖ±Ù¿¡´Â À§¾Ï ¼ö¼ú ȤÀº ³»½Ã°æ Ä¡·á ÈÄ 1-2³â Á¤µµ¸¸ ´ëÇк´¿ø¿¡¼­ °æ°ú°üÂûÀ» ÇÏ°í ±× ÀÌÈÄ´Â ¿¬°íÁö 1,2Â÷ º´¿ø¿¡¼­ ÃßÀû°Ë»ç¸¦ ¹Þµµ·Ï refer back ÇÏ´Â °æ¿ì°¡ ¸¹½À´Ï´Ù. °³¾÷°¡ ¼±»ý´Ôµé²²¼­´Â ȯÀÚ¸¦ ´Ù½Ã ´ëÇк´¿øÀ¸·Î µ¹¸®Áö ¸¶½Ã°í remnant stomachÀ» Àß °üÂûÇØ ÁÖ½Ã¸é °¨»çÇÏ°Ú½À´Ï´Ù. ºÎŹµå¸³´Ï´Ù.

À§¿°¿¡ ´ëÇÑ Ç÷û°Ë»ç (À̼±¿µ ±³¼ö´Ô)

³»½Ã°æ°ú Ç÷û°Ë»ç À̼±¿µ ±³¼ö´Ô

Anti-Helicobacter Ç×ü°¡ ¾ç¼ºÀÌ¶óµµ ¼öÄ¡°¡ ³·À¸¸é false positiveÀÎ °æ¿ì°¡ ¸¹½À´Ï´Ù.

anti-Helicobacter Ç×ü ¼öÄ¡°¡ ³ô¾Ò´ø »ç¶÷ÀÌ Á¦±ÕÄ¡·á ÈÄ Ç×ü ¼öÄ¡°¡ »ó´çÈ÷ ³·¾ÆÁö¸é ºñ·Ï ¾ç¼ºÀ̶ó°í ÇÏ´õ¶óµµ Ç︮ÄÚ¹ÚÅÍ Á¦±ÕÄ¡·á ¼º°øÀÓÀ» ÀǹÌÇÕ´Ï´Ù.

PG-II°¡ Ç︮ÄÚ¹ÚÅÍ¿¡ µµ¿òÀÌ µÇ°í PG-I´Â À§Ã༺ À§¿°¿¡ µµ¿òÀÌ µË´Ï´Ù.

PPI »ç¿ë½Ã ¿©ÀÚ¿¡¼­´Â ³³ÀÛÇÑ fundic gland polypÀÌ ¸¹ÀÌ ¹ß»ýÇÏ°í, ³²ÀÚ¿¡¼­´Â cobblestone appearance¸¦ º¸ÀÏ ¼ö ÀÖ½À´Ï´Ù.

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Refractory GERD¶ó°í À̸§ºÙÀ̱â Àü¿¡ impedance/pH °Ë»ç¸¦ ÇÏ¿© GERD¶ó´Â Áõ°Å¸¦ È®º¸ÇØ¾ß ÇÑ´Ù°í ÁÖÀåÇϼ̽À´Ï´Ù. Áõ°Å¾øÀÌ´Â PPI³ª P-CABÀ» 1´Þ ÀÌ»ó ¾²Áö ¾Ê´Â´Ù°í ´äÇϼ̽À´Ï´Ù.

È£»ê±¸ ½Äµµ¿° (¹ÚÈ¿Áø ±³¼ö´Ô)

È£»ê±¸ ½Äµµ¿° ¹ÚÈ¿Áø ±³¼ö´Ô


10) Á¦10ȸ ¼øõ¸¸³»½Ã°æ¼¼¹Ì³ª (2022)

¼øõ¸¸³»½Ã°æ¼¼¹Ì³ª°¡ ¹ú½á 10ȸ°ÀÔ´Ï´Ù. ÃàÇÏÇÕ´Ï´Ù.

Àú´Â »óÇÇÇÏÁ¾¾ç¿¡ ´ëÇÏ¿© ¹ßÇ¥ÇÏ¿´½À´Ï´Ù. Proximal stomach¿¡ À§Ä¡ÇÑ ÀÛÀº SMT¿¡ ´ëÇÑ Á¶Á÷°Ë»ç´Â ÇÊ¿äÇÏÁö ¾ÊÀ» ¼ö ÀÖ´Ù´Â Á¡À» °­Á¶ÇÏ¿´½À´Ï´Ù. Extrapulmonary paragonimiasisµµ Áõ·Êµµ ¼Ò°³ÇÏ¿´½À´Ï´Ù.


¸í´ë¼º ±³¼ö´Ô °­ÀÇ. Withdrawal timeÀ» Áõ°¡½ÃÅ°¸é interval cancer°¡ ÁÙ¾îµì´Ï´Ù. ±×·¯³ª 8ºÐ ÀÌ»ó °üÂûÇÑ´Ù°í ´õ ÀÌ»ó interval cancer°¡ °¨¼ÒÇÏÁö ¾Ê½À´Ï´Ù. 8ºÐ ÀÌ»ó °üÂûÇÒ ÇÊ¿ä´Â ¾ø´Â °ÍÀϱî¿ä?

¸í´ë¼º ±³¼ö´Ô °­ÀÇ. CapÀ» ¾²¸é ºÐ¸íÈ÷ »ðÀԽð£Àº ÁÙ¾îµì´Ï´Ù. ±×·¯³ª adenoma detection rate°¡ Áõ°¡ÇÏ´ÂÁö´Â ¸íÈ®ÇÏÁö ¾Ê½À´Ï´Ù. ¾ÆÁÖ Á¶±Ý Áõ°¡ÇÏ´Â °Í °°±â´Â ÇÕ´Ï´Ù.

[2022-4-30. ÀÌÁØÇà Áú¹®] ´ëÀå³»½Ã°æ °á°úÁö¿¡ ¿¹¸¦ µé¾î "SD junctionÀ» Åë°úÇÒ ¶§ right decubitus·Î ¹Ù²Ù¾ú´õ´Ï µµ¿òÀÌ µÇ¾ú½À´Ï´Ù. ´ÙÀ½ °Ë»ç¿¡ Âü°íÇØ ÁÖ¼¼¿ä" ¶ó´Â ±â¼úÀûÀÎ À̽´¸¦ ³²±â´Â ºÐÀÌ °è½Ê´Ï´Ù. ÀÌ·¯ÇÑ ±â·ÏÀÌ ´ÙÀ½ °Ë»ç¿¡ µµ¿òÀÌ µÇ°Ú½À´Ï±î?

[2022-4-30. Àü³²´ë ¸í´ë¼º ±³¼ö´Ô ´äº¯] ÀÚ¼¼¿¡ ´ëÇÏ¿© ±â·ÏÀ» ³²±âÁö ¾ÊÁö¸¸ »ðÀÔÀÌ ¾î·Á¿ö ½Ã°£ÀÌ ¿À·¡ °É¸° °æ¿ì´Â ±× ³»¿ëÀ» ³²°Ü³õ±âµµ ÇÕ´Ï´Ù.


PPI »ç¿ëÀÚÀÇ À§³»½Ã°æ¿¡¼­ ¹ß°ßµÇ´Â ¿©·¯ ¼Ò°ß¿¡ ´ëÇÏ¿© ±è±¤ÇÏ ±³¼ö´Ô²²¼­ ¾Ë±â ½±°Ô ¼³¸íÇϼ̽À´Ï´Ù. À§Á¡¸·¿¡ ´ëÇÑ ±¸Á¶ÀûÀÎ º¯È­ÀÔ´Ï´Ù. µÎ °¡Áö ±âÀüÀÌ Á¦½ÃµÇ¾ú½À´Ï´Ù. (1) Fundic glandÀÇ parietal cellÀÌ lumen ³»·Î buldging µÇ¸é¼­ glandÀÇ ductal dilatationµÇ´Â ±âÀü°ú (2) foveolar epithelial hyperplasiaÀÔ´Ï´Ù. (1)Àº fundic gland polypÀ̳ª cobble stone appearanceÀÇ ¿øÀÎÀÌ°í (2)´Â hyperplastic polypÀ̳ª white flat elevated lesionÀÇ ¿øÀÎÀ¸·Î ¼³¸íµÇ°í ÀÖ½À´Ï´Ù. (Gut and Liver 2021)

Suggested mechanisms of proton pump inhibitor (PPI)-related gastric mucosal changes.

Gut and Liver 2021

Histopathological features of proton pump inhibitor-related gastric mucosal changes. (A) Oxyntic mucosa with parietal cell protrusions (H&E, ¡¿200). (B) Cystic changes in fundic glands (H&E, ¡¿200). (C) Foveolar epithelial hyperplasia (H&E, ¡¿40).

Endoscopic features of proton pump inhibitor-related gastric mucosal changes. (A) Fundic gland polyps. PPI¿¡ ÀÇÇÑ fundic gland polypÀº sporadic fundic gland polypº¸´Ù cysticÇÑ °ÍÀÌ Æ¯Â¡ÀÔ´Ï´Ù. (B) Hyperplastic polyp. (C, D) Multiple white and flat elevated lesions. (E) Cobblestone-like mucosa. (F) Black spots.

Cracked mucosa. Cobblestone-like mucosaÀÇ Àü´Ü°è·Î »ý°¢µÇ°í area gastrica À§¼Ò±¸°¡ ÇöÀúÇÏ°í È®´ëÇϸé pit°¡ ¶Ñ·ÇÇØ º¸ÀÔ´Ï´Ù.

VonoprazanÀ» ¿À·¡ »ç¿ëÇϸé stardust°¡ º¸ÀÏ ¼ö ÀÖ½À´Ï´Ù.


¹ÚÈ¿Áø ±³¼ö´ÔÀÇ ¸ÚÁø Ư°­ÀÌ ÀÖ¾ú½À´Ï´Ù.

[¹ÚÈ¿Áø ±³¼ö´Ô comment] AI Ä«¸Þ¶ó°¡ surgeonÀÇ ¼Õ¾Ä±â¸¦ monitoringÇÏ¿© ¼ÕÀ» Á¤È®È÷ ¾ÄÁö ¾ÊÀ¸¸é ¼ö¼úÀå ¹®ÀÌ ¿­¸®Áö ¾Ê´Â systemÀÌ ÀÖ½À´Ï´Ù. ³»½Ã°æ¿¡ AI ´«ÀÌ ´Þ·Á À־ blind area¸¦ º¸Áö ¾ÊÀ¸¸é ³»½Ã°æÀ» »©±â Àü¿¡ alarmÀÌ ¿ï¸®´Â ¹æ½Äµµ ½ÃµµµÇ°í ÀÖ½À´Ï´Ù.


Coronary stent ÈÄ ÀϽÃÀûÀ¸·Î antiplateletÀ» ²÷´õ¶óµµ thrombus°¡ ¸¸µé¾îÁö´Â °æ±¸°¡ °ú°Åº¸´Ù ¸¹ÀÌ °¨¼ÒµÇ¾ú´Ù°í ÇÕ´Ï´Ù. Stent ÀÚüÀÇ Ç°ÁúÀÌ ÁÁ¾ÆÁö°í statin µî ¾àÁ¦µµ ÁÁ¾ÆÁ®¼­ °ú°Åº¸´Ù thrombus°¡ ´ú ¹ß»ýÇÏ°í ÀÖ½À´Ï´Ù. Decision making¿¡ Âü°íÇϸé ÁÁ°Ú½À´Ï´Ù.


[ÀÚ°¡¸é¿ªÀ§¿° - ¾È¿ëȯ]


¸Å¿ì Áß¿äÇÑ ÀÚ·á°¡ ¼Ò°³µÇ¾ø½À´Ï´Ù (J Clin Med 2021). ±¹°¡¾Ï°ËÁøÇÁ·Î±×·¥(National Cancer Screening Program)¿¡¼­ ½ÃÇàÇÑ ³»½Ã°æ °Ë»ç¿¡¼­ À§¾Ï ¹ß°ßÀ²°ú negative endoscopy ÈÄ interval cancerÀÇ ºñÀ²ÀÔ´Ï´Ù. Æò±Õ 55.6¼¼, ¿©¼º 54.6%ÀÎ ´ë»ó±º¿¡¼­ ±¹°¡¾Ï°ËÁø ³»½Ã°æ °Ë»çÀÇ ¾Ï Áø´ÜÀ²Àº 0.26%¿´½À´Ï´Ù. 400¸í °Ë»çÇϸé ÇÑ ¸íÀÌ ¾ÏÀ¸·Î Áø´ÜµÈ´Ù´Â °ÍÀÔ´Ï´Ù. 2³â À̳» ³»½Ã°æ °æÇèÀÚ¿¡¼­´Â 0.22%, 2³âÃÊ°ú 10³â À̳» ³»½Ã°æ °æÇèÀÚ¿¡¼­´Â 0.36%, 10³â ÀÌ»ó ¹«°æÇèÀÚ¿¡¼­´Â 0.49%¿´½À´Ï´Ù. Negative endoscopy ÈÄ 1³â À̳» ¾ÏÁø´ÜÀ² (= interval cancer)Àº 0.036%¿´½À´Ï´Ù.


11) Á¦11ȸ ¼øõ¸¸³»½Ã°æ¼¼¹Ì³ª (2023) + EndoGEL ESD hands-on training

¹ÚÈ¿Áø ±³¼ö´ÔÀÇ ¸ÚÁø °­ÀÇ°¡ ÀÖ¾ú½À´Ï´Ù.

RefractoryÇÑ °æ¿ì overlap, intragastric maldistribution, delayed gastric emptyingÀ» °í·ÁÇÒ ¼ö ÀÖ½À´Ï´Ù.

GERD ȯÀÚÀÇ 30-40%´Â dyspepsiaµµ °¡Áö°í ÀÖ½À´Ï´Ù.

PPI¸¦ µå½Ã¸é ¼ÒÈ­°¡ ´ú µÇ´Â ±âÀüÀÔ´Ï´Ù.

Supragastric belching ȯÀÚ¿¡°Ô º¹½ÄÈ£ÈíÀ» ±ÇÇÏ°í baclofenÀ» ½á º¼ ¼ö ÀÖ½À´Ï´Ù. Baclofen 2.5mg tid·Î ½ÃÀÛ

AmitriptylineÀ» ÇÔ²² ¸ÔÀ¸¸é õõÈ÷ Áõ»óÀÌ ÁÁ¾ÆÁø´Ù°í ÇÕ´Ï´Ù.

ÃÖ¼®Ã¤ ±³¼ö´ÔÀÇ °­ÀǸ¦ Àß µé¾ú½À´Ï´Ù.

¼ÒÈ­±â Áúº´¿¡´Â ¼¼ °³ÀÇ domainÀÌ ÀÖ½À´Ï´Ù. (1) Organic, (2) motility, (3) functional. ·Î¸¶ ºÐ·ù¿¡¼­ functional GI disorder¸¦ disorders of gut-brain interactionÀ̶ó°í ºÎ¸¨´Ï´Ù.

Stress°¡ brain-gut dysfunction¿¡ ¹ÌÄ¡´Â ¿µÇâÀº Áö´ëÇÕ´Ï´Ù.

pH test°¡ ºñÁ¤»óÀÎ °æ¿ì¸¸ NERD·Î ºÎ¸£´Â °ÍÀÌ ÁÁ°Ú½À´Ï´Ù. pH°¡ Á¤»óÀÎ °æ¿ì Áß reflux hypersensitivity´Â 40%, functional heartburnÀÌ 60%ÀÔ´Ï´Ù.

ÃÖ¼®Ã¤ ±³¼ö´Ô²²¼­ GERDÀÇ Ä¡·á¿¡¼­ °­Á¶ÇϽŠ°ÍÀº ¾Æ·¡ ¼¼ °¡ÁöÀÔ´Ï´Ù.

PSPW (post-reflux swallow-induced peristaltic wave)¿Í MNBI (mean nocturnal baseline impedence)°¡ »õ·Ó°Ô ¶°¿À¸£´Â ÁöÇ¥¶ó°í ÇÕ´Ï´Ù.

Frazzoni 2022

½Äµµ¿îµ¿Áúȯ, EGJOO (esophagogastric junction outflow obstruction)¿¡ ´ëÇÏ¿© high resoluation manometry°ú FLIP panometry·Î ½ÄµµÀÇ ¹®Á¦ÀÎÁö EGJÀÇ ¹®Á¦ÀÎÁö ±¸ºÐÇÏ¿© ÀÌ»ó ¼Ò°ß¿¡ µû¶ó °³º°ÀûÀÎ Ä¡·á¸¦ ¼±ÅÃÇÒ ¼ö ÀÖ´Â ½Ã´ë°¡ µÇ¾ú½À´Ï´Ù.

Carlson 2021

ȯÀÚ¸¶´Ù psychological factor°¡ ´Ù¸¨´Ï´Ù. EPS¿Í PDS´Â ÀüÇô ´Ù¸¥ ÁúȯÀÔ´Ï´Ù. ¼ÒÈ­±â³»°ú¿Í Á¤½Å°ú°¡ ÇÔ²² Áø·áÇÏ´Â ½Ã½ºÅÛÀÌ ±¸ÃàµÇ¾î¾ß ÇÕ´Ï´Ù.

ÃÖ¼®Ã¤ ±³¼ö´ÔÀÇ °­ÀÇ´Â ½ÄµµÁúȯ Ä¡·á¹ý¿¡ ´ëÇÏ¿© ÇÑ ÀåÀÇ ½½¶óÀ̵å·Î ¸ÚÁö°Ô ¸¶¹«¸®µÇ¾ú½À´Ï´Ù.

EndoGEL ESD hands-on trainingµµ ÇÔ²² ÁøÇàµÇ¾ú½À´Ï´Ù.

Áö¿ª ¹æ¼Û±¹¿¡ ¼Ò°³µÇ¾ú½À´Ï´Ù.


12) Á¦12ȸ ¼øõ¸¸³»½Ã°æ¼¼¹Ì³ª (2024) + EndoGEL ESD hands-on training


[References]

1) EndoTODAY Conferences

2) ¼øõ¸¸³»½Ã°æ¿¬±¸È¸ ¼±»ý´Ôµé²² - 2019³â Âü¼®Ä¡ ¸øÇÏ¿© Á˼ÛÇÑ ¸¶À½¿¡ ÆíÁö¸¦ º¸³Â½À´Ï´Ù.

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