Panendoscopyの有用性

The Applicability of Panendoscopy in Gastric Endoscopy

要旨　胃内視鏡検査におけるpanendoscopyの有用性について，われわれの経験とアンケートをもとに検討した．いわゆる細径，中径のpanendoscopeの出現により，胃を含めた上部消化管のスクリーニング検査をはじめ，広くpanendoscopeが使用されるようになった．従来の内視鏡に比較し，操作性，観察能に優れ，また，被検者の苦痛が軽減されたからである．これらのプラス評価は，われわれの胃集検，臨床のデータ，日本消化器内視鏡学会評議員のアンケート回答からも得られている．現時点でのpanendoscopyの問題点は，胃体部後壁の観察の不利，記録性の不良であろう．また，被検者の苦痛も，検者が考えるほど軽減されてはいない．胃の内視鏡検査は，X線に比較し，立体感，色調の情報に優れ，被曝の問題もなく，今後，X線に代わり胃スクリーニング検査は，panendoscopyとなるであろう．しかし，胃内視鏡検査の将来を考えるとき，panendoscopyの問題点の解決は，現在の器械の改善で解決されるであろうか．極端に言えば，現在のグラスファイバーを中心とする機構では限界に達しているのではなかろうか．更に優れた操作性，観察能，記録性を求めて，また，被検者の苦痛を減らすためには，根本的にその構造を考え直す必要があるのではないかと思っている．

　An evaluation of the use of panendoscopy in gastric endoscopy was made through a study of opinionaires and past experiences.

　With the introduction of the so-called small and medium size diameter tube panendoscope, panendoscopy is now widely used in various investigations such as in examination of the upper GI tract including the stomach. The reason being that compared to the conventional endoscope, it is far superior in handling methods, in observation capabilities, and moreover, it has lessened the discomfort the patient ordinarily experiences during its use. The same result is seen in mass surveys, clinical data, and in questionaires answered by councillors of the Academy of Japanese Gastroenterological Endoscopy.

　Presently, the problems involved in panendoscopy are disadvantageous in viewing the posterior wall of the gastric body and difficulties in recording data. Furthermore, the discomfort experienced by patients are not decreased to a great extent.

　Nevertheless, gastric endoscopy surpasses the x-ray method in presenting information with dimension and tones of color and shows no problems in exposure. Thus certainly, panendoscopy will replace the x-ray in gastric screening examinations in the future.

　However, will improvements in the present apparatus solve the problems panendoscopy presents? In short, the mechanism using mainly glass fibers shows limits. A thorough reconsideration of its structure is required in order to excel in operation, observation, and recording standards, and also in decreasing the discomforts the patients go through.