GTFとその役割

The Role of the GTF Type Gastrocamera in Gastric Endoscopy

要旨　panendoscopeが著しく普及している今日におけるGTFタイプの意義は側視鏡であることと先端胃カメラによる優れた写真が撮れることにある．panendoscopeが全上部消化管の内視鏡検査ができるのに対して，GTFタイプは胃専用である．GTFタイプは胃カメラにファイバースコープが付いたもので広義の胃カメラとも言える．最近のGTFは先端ランプとライトガイドによる照明方式とがあり，それぞれに生検のできないSタイプと生検のできるBタイプがある．GTFタイプでは観察に引き続いて優れた胃カメラ写真撮影が可能であり，その写真を詳細に読影して診断を行う．この写真の読影によって，観察時に見逃された病変が発見されることがあり，GTF写真の読影は極めて重要である．panendoscope写真は近年著しく良くなったが，一般には観察時の診断に主力が置かれている．GTFタイプは側視鏡であるため，食道や噴門に禁忌となるような疾患のないことをX線検査またはpanendoscope検査で確かめることを原則としている．panendoscope検査は容易であるためにX線とGTF検査にとって代わりつつあるが，より詳細な胃疾患の診断や経過追跡にはGTFタイプを用いるべきであろう．

　The significance of the GTF type gastrocamera in light of the marked increase of the panendoscope today lies in the fact that it is a side-viewing fiberscope and high quality photographs can be obtained by the camera situated at the tip. The panendoscope can be used for endoscopy of all of the upper GI tract whereas the GTF type is used strictly for the stomach. The GTF type is a gastrocamera with a fiberscope attached and thus, it can be called a gastrocamera in its broad sense. The recent GTF adopts a method of illumination using the lamp tip as well as a light guide. These consist of the S-type with which biopsy cannot be performed and the B-type with which biopsy is possible.

　Next to the high observational capacity of the GTF type, it makes possible the taking of outstanding photographs using the gastrocamera and diagnosis is made by a detailed reading of these pictures. At times, lesions left undetected during observation are discovered later with this method and therefore, the reading of GTF photographs is extremely vital.

　There have been recent progress in improving panendoscopic pictures, however generally, emphasis is laid on diagnosis during observation. Due to the fact that the GTF type is a side-viewing fiberscope, one must abide by the basic rule to confirm that the patients possess no diseases such as in the esophagus and cardia which make this method of examination contraindicated to certain patients.

　Because panendoscopy is easy to perform, it is gradually replacing the x-ray and GTF method. However, the GTF should be used in order to make a more detailed diagonsis as well as follow-up.