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RISS 인기검색어
- 검색키워드
- 저자 : ( Masakatsu Fukuzawa ) (검색결과 2 건)
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Significance of rescue hybrid endoscopic submucosal dissection in difficult colorectal cases
Hayato Yamaguchi,Masakatsu Fukuzawa,Takashi Kawai,Takahiro Muramatsu,Taisuke Matsumoto,Kumiko Uchida,Yohei Koyama,Akira Madarame,Takashi Morise,Shin Kono,Sakiko Naito,Naoyoshi Nagata,Mitsushige Sugimo 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.6
Background/Aims: Hybrid endoscopic submucosal dissection (ESD), in which an incision is made around a lesion and snaring is per-formed after submucosal dissection, has some advantages in colorectal surgery, including shorter procedure time and preventing per-foration. However, its value for rescue resection in difficult colorectal ESD cases remains unclear. This study evaluated the utility of res-cue hybrid ESD (RH-ESD). Methods: We divided 364 colorectal ESD procedures into the conventional ESD group (C-ESD, n=260), scheduled hybrid ESD group(SH-ESD, n=69), and RH-ESD group (n=35) and compared their clinical outcomes. Results: Resection time was significantly shorter in the following order: RH-ESD (149 [90–197] minutes) >C-ESD (90 [60–140] min-utes) >SH-ESD (52 [29–80] minutes). The en bloc resection rate increased significantly in the following order: RH-ESD (48.6%), SH-ESD (78.3%), and C-ESD (97.7%). An analysis of factors related to piecemeal resection of RH-ESD revealed that the submucosal dis-section rate was significantly lower in the piecemeal resection group (25% [20%–30%]) than in the en bloc resection group (40% [20%–60%]). Conclusions: RH-ESD was ineffective in terms of curative resection because of the low en bloc resection rate, but was useful for avoid-ing surgery.
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( Masaya Nonaka ),( Takuji Gotoda ),( Chika Kusano ),( Masakatsu Fukuzawa ),( Takao Itoi ),( Fuminori Moriyasu ) 대한소화기학회 2015 Gut and Liver Vol.9 No.1
Background/Aims: Propofol sedation for elderly patients during time-consuming endoscopic procedures is controversial. Therefore, we investigated the safety of using propofol in elderly patients during upper gastrointestinal therapeutic endoscopy. Methods: The medical records of 160 patients who underwent therapeutic endoscopic procedures under gastroenterologist- guided propofol sedation at a single institution were retrospectively reviewed. The subjects were divided into two groups: a younger group, patients <75 years old; and an elderly group, patients ≥75 years old. The two groups were compared with respect to the therapeutic regimen, circulatory dynamics, and presence/absence of discontinuation of propofol treatment. Results: Although the number of patients with liver dysfunction was higher in the elderly group, there were no other significant differences in the baseline characteristics, including the American Society of Anesthesiologists classification, between the elderly and younger groups. The average maintenance rate of continuous propofol infusion was lower in the elderly patients. No statistically significant differences were found in the occurrence of adverse events between the elderly and younger groups. None of the patients returned to a resedated state after the initial recovery from sedation. Conclusions: Gastroenterologist-guided propofol sedation in elderly patients can be safely achieved in the same manner as that in younger patients, even for timeconsuming upper gastrointestinal therapeutic endoscopic procedures. (Gut Liver 2015;9:38-42)
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