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
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.