Te otinga whakararu o te endoscopy hauora i roto i te tātaritanga me te maimoatanga o nga mate gastrointestinal

1, Nga pakaruhanga whakararu i roto i te mara o te tātaritanga

1. Whakamutunga Kapene Ahokore (WCE)

Whakararuraru: Whakaotihia te "waahi matapo" o te whakamatautau whekau iti ka whakakapi i te momo pana tawhito endoscope whekau iti mamae.

Whakahou Hangarau:

I awhinahia e AI te tātaritanga: penei i te PillCam SB3 a Given Imaging's, he mea taputapu ki te hangarau reiti anga urutau, ka tohu aunoa a AI i nga tohu whakaheke toto/mamao (tairongo>90%).

Ko te gastroscopy capsule e whakahaere ana aukume (pēnei i te NaviCam mai i te Hangarau Anhan): te whakahaere tika i te hurihanga o te kapene ma te papa autō o waho ka taea te tirotiro matawhānui o te puku, me te tika o te tirotiro wawe mo te mate pukupuku pekiti he rite ki te gastroscopy tuku iho (>92%).

Ko te potae koiora (waahanga whakamatautau): penei i te kapene rawhi moroiti i hangaia e te roopu rangahau o Korea ki te Tonga, ka taea te whakahaere mamao mo te whakatauira.

2. Hangarau endoscopic poke mohio

Atahanga Whakaitinga (NBI):

Maataupono: 415nm/540nm te rama hianga whaiti ka whakarei ake i te rerekee o te mucosal vascular.

Painga whakararuraru: Kua piki ake te reiti kitenga o te mate pukupuku puku moata mai i te 45% i roto i te whakamaarama maamaa maamaa ki te 89% (e ai ki te paerewa JESDS Japanese).

Atahanga Hononga (LCI):

Painga: Ko te algorithm arai a Fuji he 30% teitei ake te reeti mo te gastritis papa me te metaplasia intestinal ki te NBI.

3. Whakamutunga Taiaho Whakamutunga (pCLE)

Tohu Hangarau: Ko te diameter o te rangahau he 1.4mm anake (pērā i te Pūnaha Cellvizio), ka tutuki i te wā-tūturu te mātakitaki taumata pūtau i te whakanuinga o te 1000 wa.

Uara haumanu:

Te tautuhi tere o Barrett's esophageal dysplasia hei karo i nga biopsies tukurua.

Ko te uara matapae kino mo te aro turuki i te mate pukupuku ulcerative colitis he 98%.

2、 Nga rongoā hurihuri i roto i te waahi maimoatanga

1. Wehenga mucosal endoscopic (ESD)

Te pakaruhanga hangarau:

Naipi hiko bipolar (pēnei i te FlushKnife BT): ka whakaitihia te whaowhia o te tote i te tupono o te pakaru.

CO ₂ laser te awhina: te whakapoitanga tika o te paparanga submucosal, te toto toto<5ml.

Raraunga haumanu:

Neke atu i te 95% te reeti tangohanga whakaora mo te mate pukupuku puku moata, a ko te reeti oranga mo te 5 tau he rite ki te pokanga tuku iho (neke atu i te 90%).

Ko te rangahau DDW i te United States e whakaatu ana ko te reeti tangohanga katoa o te koroni lateral developmental tumors (LST) nui ake i te 3cm he 91%.

2. Te pokanga endoscopic ma te kohao maori (NOTE)

Nga tikanga pokanga maangai:

Transgastric cholecystectomy: Ka whakamahia te Olympus TriPort maha-channel endoscope, ka pau te kai i te 24 haora i muri i te pokanga.

Transrectal appendectomy: Ko te roopu Korea ki te Tonga te korero mo te keehi angitu tuatahi o te ao i te tau 2023.

Nga taputapu matua: Rawhi katia te paparanga katoa (pērā i te OTSC) ®） Whakatauhia te wero nui o te NOTES - katinga ana.

3. Tapahanga matotoru-katoa endoscopic (EFTR)

Te tohu tohu: Te maimoatanga o nga pukupuku stromal gastric (GIST) i ahu mai i te paparanga uaua o roto.

Kī Hangarau: Laparoscopic endoscopic combined surgery (LECS) e whakarite haumaru.

Nga taputapu tuitui hou (penei i te OverStitch) ™） Me mohio ki te tuitui paparanga katoa.

3、 Kaupapa whakauru mo te mate pukupuku me te maimoatanga

1. Endoscopic arahina radiofrequency ablation (EUS-RFA)

Te maimoatanga o te mate pukupuku pancreatic: I whakauruhia te ngira 19G ki roto i te tirotiro RF, a ko te reeti whakahaere o te rohe ko te 73% (≤ 3cm te puku).

Ka whakatauritea ki te pokanga tuwhera, kua heke te reeti whakapoauau mai i te 35% ki te 8%. Te tono mo te mate pukupuku ate: Ko te whakakore i nga pukupuku o te duodenal i roto i te kopa o te ate.

2. Korekorero navigation pokanga endoscopic

Hangarau tapanga ICG: Werohia ki roto i te toto o mua, te endoscopy tata-infrared (pēnei i te Olympus OE-M) hei whakaatu i te awhe wai rere lymphatic. Ko te kakatotanga o te wehenga ngongo lymph i te wa o te pokanga mate pukupuku o te kopu ka pai ake ma te 27%.

Ko nga rangahau karewharewha kua whakaritea (waahi whakamatautau): penei i te MMP-2 nga rangahau aro turuki, ka tapaina nga metastases iti.

4、 Te Whakahoutanga i roto i nga ahuatanga ohotata me te tiaki arohaehae

1. Ko te toto o te gastrointestinal

Hemospray hemostatic paura:

I raro i te rehu endoscopic, ka hangaia he arai miihini, me te tere hemostasis o 92% (Forrest Grade Ia bleeding).

Neke atu i te Topenga Awhiowhio (OTSC):

Ko te hoahoa "Bear Claw", ka kati i te kohao whewhe ki te 3cm te diameter.

2. Ko te whakaheke i te mutunga mo te aukati i te whekau

Taiapa whakarewa whaiaro (SEMS):

Ko te rongoa piriti mo te aukati i te koroni kino, me te reeti whakaora neke atu i te 90% i roto i te 48 haora.

Nga taiapa tapahi taiaho hou (penei i te Niti-S) ™） Whakaitihia te reeti neke ki te 5%.

5、 Nga tohutohu hangarau a meake nei

1. Pūnaha whakatau whakatau wā-tūturu AI:

Pērā i a Cosmo AI ™ Me mohio aunoa i te tere tangohanga i te wa e tirotirohia ana e te koroni, e whakaiti ana i te mate adenoma i ngaro (kua piki te ADR ma te 12%).

2. Endoscope capsule degradable:

Ko te anga konupora koranu + anga waikawa polylactic, ka rewa i roto i te tinana i roto i te 72 haora i muri i te tirotiro.

3. Endoscope karetao moroiti:

Ko te "karetao origami" mai i ETH Zurich ka taea te hanga hei papa pokanga mo te whakatauira.

Ripanga Whakatauritenga Haumanu

Nga whakaaro whakatinanatanga

Nga hōhipera pakiaka: Me hoatu te kaupapa matua ki te whakauru i te mana aukume kapipi gastroscopy+OTSC pūnaha hemostatic.

Ko te hohipera o te akomanga tuatoru: E taunaki ana kia whakatuu he pokapū maimoatanga mate pukupuku ESD+EUS-RFA.

Arataki Rangahau: Arotahi ki te AI pathology tātaritanga wa-tūturu+whakapae karetao whakaheke.

Ko enei hangarau kei te hanga ano i te taatai ​​me te maimoatanga o nga mate gastrointestinal na roto i nga huarahi nui e toru: kaore i te whakaeke, te tika, me te mohio. Me whakakotahi te tono tuuturu me nga rereketanga o te manawanui me te urunga o nga rauemi rongoa.