新しい胃生検法“strip”biopsyの開発

New Technique of Gastric Biopsy

要旨　従来の鉗子生検では，採取材料の大きさや深さが不十分である．これを補うため，われわれは“strip”biopsyを開発した．この“strip”biopsyとは，粘膜下に注射用生理食塩水を2～4ml注入し，山田Ⅱ～Ⅲ型の隆起を形成し，スネアを装着したのち，高周波電流にて切除する方法であり，病変部の陥凹，隆起に関係なく直径2～3cmの粘膜を広範に生検することが可能である．この方法は慢性胃炎の診断のみならず，異型上皮巣や，小胃癌の完全な切除が可能であり，生検組織学的診断のみならず，内視鏡的治療法としても有効であった．なお本生検によるとう痛，出血などの副作用はほとんどなく，生検によって生じた潰瘍は2～3週間で治癒し，安全でかつ確実な生検法である．

　The biopsy specimens obtained by conventional bite biopsy technique are too small and too superficial in many cases. To lessen this drawback, we developed a new biopsy technique under direct visual control called strip biopsy. Under fiberoptic observation, we injected physiologic saline solution around the aimed lesion and made a mucosal elevation. Then, the elevation was resected by electro-coagulation. Afer resection we removed the specimen by grasp forceps.

　According to this strip biopsy technique, we could remove specimens about 2-3 cm in length even when the lesion was flat or depressed. We succeeded total resection of a specimen of Group Ⅲ atypical mucosa and could easily remove the minute gastric cancer.

　Endoscopic observation revealed that the ulcer made by this procedure healed within 2-3 weeks. Obvious side effects such as bleeding and pain were not observed.