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상부위장관 용종성 병변 265예의 내시경 및 병리조직 소견에 대한 연구
설상영,장윤식,윤상조,주남영,김민기,이상욱 인제대학교 1998 仁濟醫學 Vol.19 No.2
저자는 1988년 7월부터 1997년 12월까지 부산백병원에서 내시경 검사를 통해 상부 위장관의 용종성 병변이 확인된 265명 환자의 274 용종성 병변에서 용종을 올가미법, 박리 생검술, "O" ring 결찰술을 이용하여 절제술을 시행하였으며, 이들을 대상으로 임상적 및 조직학적 소견을 분석하였다. The gastrointestinal polyp is a premalignant lesion in varying degree. Polyps in the gastrointestinal tract can be removed by surgical excision, electrosurgical method, cryotherapy, regional radiotherapy and laser therapy with some limitations. Advance in fibroptic endoscopy have improved diagnostic capabilities and management in patients with gastrointestinal polyps and endoscopic polypectomy is the most simple and safe method in removal of these polyps. We have underwent endoscopic snare polypectomy, strip biopsy and "O"ring ligation on upper gastrointestinal tract polyps in 274 lesions of 265 patients who visited in Pusan Paik hospital from July 1988 to December 1997, and the clinical characteristics including histopathology has been evaluated. The results obtained were as follows : 1) The age distribution of patients were from 28-year old to 78-year old. The ratio of male to female was 1:1.45. 2) The common clinical symptoms presented were epigastric discomfort (38.4%), epigastric pain (28.1%) and indigestion (19.6%). 3) The number of patient wish single gastric polyp was 225(85%), and that of multiple gastric polyps was 40(15%). 4) The most common location of gastric polyps was antrum(47.2%) and followed by body(37.5%) and fungus(9.1%). 5) The removed polyps were mostly 0.5∼1cm(44.8%) in size and in the gross findings by Yamada classifications type II(41.9%) was most common. 6) Histological examinations of gastric polypoid lesions revealed that 63.1% of removed polyps were hyperplastic polyps and 24% of 7hose were adenomatous polyps. 7) Almost all cases showed no significant complication, but there were postpolypectomy abdominal pain in 20 cases(7.5%) and minor bleeding in 8 cases(3.0%). Finally, we concluded that endoscopic polypectomy is a safe and relatively simple procedure and postpolypectomy complication can be considerably reduced by conservative antiulcer therapy, So. most of polypoid lesions of upper gastrointestinal tract should be removed and meticulous pathological review is mandatory.
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금속성 Clip을 조기위암의 수술전 표식자로 사용한 1례
설상영,김환태,이상혁,정정명,최하진,최영길,김영주 인제대학교 1994 仁濟醫學 Vol.15 No.3
조기위암환자에서 금속성 clip을 이용하여 병변의 상부 경계부에 표식을 시행하여 수술시행시 일차적인 병소확인 및 절제 범위결정에 도움을 준 1례를 경험 하였기에 보고하는 바이다. Early gastric cancer has a good prognosis with early diagnosis and curative surgery, 5 year survival rate reaching up to 95% But in the case of small and superficial lesion sometimes it is very diffiuclt to point out actual lesion in the operative field and this will pose considerable difficulty in deciding resection margin. We used HX-3 metal clip(Olympus Corp.) as a gross marker of EGC through gastrofiberscope and this clip offered remarkable ease in identifying actual lesion in the operative field. We report this case with the review of the literature.
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