Kusokoneza njira ya mankhwala endoscopy mu matenda ndi mankhwala a m`mimba matenda

1, Zosokoneza pagawo la matenda1. Wireless Capsule Endoscopy (WCE) Zosokoneza: Yambitsani kwathunthu "malo osawona" pakuwunika kwamatumbo ang'onoang'ono ndikusintha chikhalidwe chowawa.

1, Zosokoneza pakufufuza

1. Wireless Capsule Endoscopy (WCE)

Zosokoneza: Yatsani kwathunthu "malo osawona" a matumbo ang'onoang'ono ndikuyesa matumbo ang'onoang'ono endoscope.

Kusintha kwaukadaulo:

Kuzindikira kothandizidwa ndi AI: monga Given Imaging's PillCam SB3, yokhala ndi ukadaulo wosinthira mawonekedwe, AI imadziyika yokha zilonda zamagazi (sensitivity> 90%).

Magnetic controlled capsule gastroscopy (monga NaviCam yochokera ku Anhan Technology): kuwongolera kolondola kwa kapisozi ndi maginito akunja kumathandizira kufufuza m'mimba, komanso kuwunika koyambirira kwa khansa ya m'mimba ndikufanana ndi gastroscopy yachikhalidwe (> 92%).

Kapisozi wa biopsy (gawo loyesera): monga kapisozi kakang'ono kakang'ono kopangidwa ndi gulu lofufuza laku South Korea, lomwe limatha kuwongoleredwa patali kuti lizitsatira.

2. Wanzeru kudetsa endoscopic luso

Narrowband Imaging (NBI):

Mfundo: 415nm/540nm yopapatiza sipekitiramu kuwala kumawonjezera mucosal mtima kusiyana.

Zosokoneza: Kuzindikira kwa khansa ya m'mimba yoyambilira kwakwera kuchoka pa 45% mu endoscopy yowala yoyera mpaka 89% (malinga ndi muyezo waku Japan wa JESDS).

Kujambula kwa Linkage (LCI):

Ubwino: Ma algorithm ovomerezeka a Fuji ali ndi kuchuluka kwa 30% kuzindikirika kwakukulu kwa gastritis ndimatumbo am'mimba poyerekeza ndi NBI.

3. Confocal Laser Endoscopy (pCLE)

Zowunikira paukadaulo: Kuzama kwa probe ndi 1.4mm kokha (monga makina a Cellvizio), kukwaniritsa mawonekedwe a cell nthawi yeniyeni pakukulitsa nthawi 1000.

Mtengo wachipatala:

Kuzindikiritsa mwachangu kwa Barrett's esophageal dysplasia kuti mupewe ma biopsies mobwerezabwereza.

Ubwino wolosera woyipa wowunikira ulcerative colitis carcinogenesis ndi 98%.


2. Kusintha njira m'munda wa mankhwala

1. Endoscopic mucosal dissection (ESD)

Kupambana kwaukadaulo:

Bipolar electric mpeni (monga FlushKnife BT): kulowetsedwa kwa saline kumachepetsa chiopsezo choboola.

CO ₂ laser inathandizira: kutsekemera kolondola kwa submucosal wosanjikiza, kuchuluka kwa magazi <5ml.

Zambiri zachipatala:

Chiwopsezo chochiritsa khansa ya m'mimba yoyambirira ndi yoposa 95%, ndipo kupulumuka kwazaka zisanu ndikufanana ndi opaleshoni yachikhalidwe (kupitilira 90%).

Kafukufuku wa DDW ku United States akuwonetsa kuti kuchuluka kwa zotupa za colon lateral developmental tumors (LST) zazikulu kuposa 3cm ndi 91%.

2. Opaleshoni ya Endoscopic kudzera m'mitsempha yachilengedwe (ZOYENERA)

Njira zoyimira opaleshoni:

Transgastric cholecystectomy: Olympus TriPort multi-channel endoscope imagwiritsidwa ntchito, ndipo chakudya chimadyedwa maola 24 pambuyo pa opaleshoni.

Transrectal appendectomy: Gulu laku South Korea likunena za mlandu woyamba wopambana padziko lonse lapansi mu 2023.

Zida zapakati: Chingwe chotseka chathunthu (monga OTSC) ®) Konzani vuto lalikulu la ZINSINSI - kutsekedwa kwa zibowo.

3. Endoscopic full-thickness resection (EFTR)

Kupambana kosonyeza: Chithandizo cha zotupa za m'mimba (GIST) zochokera mu minofu yamkati.

Kiyi yaukadaulo: Opaleshoni yophatikizika ya Laparoscopic endoscopic (LECS) imatsimikizira chitetezo.

Zida zatsopano za suture (monga OverStitch) ™) Zindikirani kusoka kwathunthu.


3, Integrated chiwembu kwa chotupa matenda ndi chithandizo

1. Endoscopic guided radiofrequency ablation (EUS-RFA)

Chithandizo cha khansa ya kapamba: singano yoboola 19G idalowetsedwa mu kafukufuku wa RF, ndipo kuwongolera komweko kunali 73% (≤ 3cm chotupa).

Poyerekeza ndi opaleshoni yotsegula, chiwopsezo chazovuta chatsika kuchokera ku 35% mpaka 8%. Kugwiritsa ntchito khansa ya m'chiwindi: Kuchotsa zotupa za m'mimba mwa caudate lobe ya chiwindi.

2. Fluorescent navigation endoscopic opaleshoni

Ukadaulo wakulemba za ICG: Jakisoni wolowera m'mitsempha isanayambike, pafupi ndi infrared endoscopy (monga Olympus OE-M) kuti awonetse kuchuluka kwa madzi am'madzi. Kukwanira kwa lymph node dissection panthawi ya opaleshoni ya khansa ya m'mimba kumawonjezeka ndi 27%.

Zofufuza za fulorosenti (gawo loyesera): monga ma enzyme a MMP-2 oyankha ma enzyme, makamaka amalemba ma metastases ang'onoang'ono.


4, Zatsopano mu Zochitika Zadzidzidzi ndi Zosamalitsa Zovuta

1. Kutaya magazi kwambiri m'mimba

Hemospray hemostatic ufa:

Pansi pa kupopera mbewu mankhwalawa, chotchinga chamakina chimapangidwa, chokhala ndi hemostasis ya 92% (Forrest Grade Ia magazi).

Over The Scope Clip (OTSC):

O "Bear Claw" kapangidwe, kutseka chilonda perforation ndi awiri a mpaka 3cm.

2. Endoscopic decompression kwa kutsekeka kwa matumbo

Bracket yachitsulo yodzikulitsa (SEMS):

Thandizo la mlatho la kutsekeka kwa m'matumbo owopsa, ndikuchepetsa kwa 90% mkati mwa maola 48.

Mabulaketi atsopano odula laser (monga Niti-S) ™) Chepetsani masinthidwe mpaka 5%.


5. Mayendedwe aukadaulo amtsogolo

1. Njira yopangira zisankho zenizeni zenizeni za AI:

Monga Cosmo AI ™ Zindikirani mwachangu kuthamangitsidwa pakuwunika kwa colonoscopy, kuchepetsa adenoma yophonya kuzindikira (ADR idakwera ndi 12%).

2. Degradable capsule endoscope:

Magnesium alloy frame + polylactic acid chipolopolo, imasungunuka m'thupi mkati mwa maola 72 mutayang'ana.

3. Micro robot endoscope:

"Loboti ya origami" yochokera ku ETH Zurich ikhoza kupangidwa kukhala nsanja yopangira ma sampuli.


Tchalitchi Chofananitsa Chotsatira Chachipatala

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Malingaliro okhazikitsa

Zipatala za Grassroots: Chofunika kwambiri chiyenera kuperekedwa pakukonzekeretsa kapisozi kapisozi gastroscopy + OTSC hemostatic system.

Chipatala chachitatu: Ndikofunikira kukhazikitsa malo ochizira khansa a ESD + EUS-RFA ochepa.

Kalozera wa kafukufuku: Yang'anani kwambiri pa AI pathology kusanthula zenizeni zenizeni +kuwonongeka kwa robotic endoscopy.

Ukadaulo uwu ukumanganso njira yodziwira matenda am'mimba ndikuchiza matenda am'mimba kudzera m'njira zazikulu zitatu: zosasokoneza, zolondola, komanso zanzeru. Kugwiritsa ntchito kwenikweni kuyenera kuphatikizidwa ndi kusiyana kwa wodwala aliyense payekha komanso kupezeka kwa chithandizo chamankhwala.