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Endoscopic Gastric Polypectomy with High Frequency Currents Y. Oguro 1 1Dept. of Internal Medicine, National Cancer Center Hospital pp.309-316
Published Date 1974/3/25
DOI https://doi.org/10.11477/mf.1403111775
  • Abstract
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 Progress of endoscopic diagnosis along with improved instruments has now made it possible to excise polyp of the colon by means of high frequency current. Over the years the author has studied the application of this technique to the excision of gastric polyp, and now it has become a safe procedure and the technique is clinically well established. In this paper are put forth general remarks about endoscopic polypectomy of the stomach with some reference to endoscopic excision of duodenal polyp that is now also made possible.

 At the outset the author contrived a transformer generating high frequency current solely for the use of endoscope. The transformer was characterized by heightened safety and effectiveness and also by guarding against high tension current with the adoption of high frequency blend waves. Trial manufacture has also been made of several kinds of loop wire for excision, rod wire for cautery and forceps for excision and catching the severed polyp, with their merits and demerits compared with one another. Furthermore, side-viewing 2-channel gastrofiberscope of large caliber for treatment has been devised by the author together with other fiberscopes for treatment. Their relative merits have been appraised.

 Clinical results obtained by the above-mentioned instruments are summarized as follows: For guarding against massive bleeding, it is safer to confine this maneuver to subpedunculated or pedunculated polyp. Broad-based polyp should be avoided. The size of the stalk's basis is more important than the greatest diameter of the polyp itself. Too strong current should naturally be avoided because of increasing chance of bleeding, deepening of ulcer or perforation. The site of shaving off the stalk should be several mm away from the mucosal surface. If too close, ulcer may develop over the mark of injury. For this purpose, 2-channelled side-view fiberscope of larger caliber is needed. When the injured part is either flat or eroded one day after high frequency excision, the mean time for its epithelialization is 11 days. In shallow ulcer, it is 23 days, and in deeper ulcer, 33 days. It is of great interest that as compared with other preventive measures of gastric ulcer the days needed for. healing of ulcer cauterized with high frequency current are far shorter.

 The author is now of the opinion that as gastric polypectomy represents only a curative procedure, atypical epithelium and gastric cancer of protruding type can also be subjected to the present procedure.


Copyright © 1974, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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