大腸ポリペクトミーの偶発症

Accidental Complications in Endoscopic Polypectomy of Colonic Polyps

要旨　診断と治療を目的とした大腸ポリペクトミーの意義は大きく，今日盛んに行われている．しかし，その反面これに伴う偶発症もまた増加している．この偶発症に関して，1977年から1982年までの6年間におけるわが国の実態をアンケート調査した結果をもとに参考事項や問題点を指摘した．6年間に施行された大腸ポリペクトミー18,668例中115例0.616％に偶発症をみている．偶発症としては穿孔37例，出血67例と両者が大半を占めている．死亡は3例で，その頻度は0.016％である．最近は小児についても大腸ポリペクトミーが行われているが，偶発症は成人よりも起こりやすいので十分慎重でなければならない．偶発症をできるだけ防ぐためには，内視鏡に対する教育の徹底と，より安全な方法および対策を工夫することが必要である．

　Endoscopic polypectomy of colonic polyps is extremely meaningful because polypectomy is both a diagnostic and a therapeutic procedure and it is currently carried out now. However, the incidence of accidental complications is increasing on the other side.

　The questionnaire concerning present state of accidental complications with endoscopy in the past six years from 1978 to 1982 was conducted on 697 hospitals in Japan. Based on these data, reference matters and some problems were pointed out.

　The overall incidence of accidental complications in endoscopic polypectomy of colonic polyps was 0.616% (115/18, 668), Perforation and bleeding consisted of most of them; perforation in 37 cases and bleeding in 67 cases respectively. Death was reported in three cases (0.016%).

　Recently, endoscopic polypectomy of colonic polyps in pediatric patients is performed. It should be emphasized to pay special attention because accidental complications occur more easily in children than in adults.

　It is necessary to conduct through education of endoscopy and to devise safer method and countermove in order to prevent accidental complications as much as possible.