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아이디,비밀번호찾기 / 회원가입
홈 > 내과 > Gastroenterology          
도서명 : 대장 ESD - 안전한 수기 도입을 위한 (DVD 포함)
저자명 : 한동수 역/다나카 신지 저
출판사 : 대한의학서적
ISBN 9788994467535
경로 내과 > Gastroenterology
페이지 139 page
발행일2020
정가 100,000 원
판매가격 90,000 원 (10% ↓)
적립금 1,800 원 (2%)
판매여부 판매
주문수량
         
복부영상진단 - 이것
Clinical Gastrointes
소화기내시경아틀라스
실전 소화기내시경 가
소화기내시경아틀라스
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1 장 대장 ESD의 적응
Ⅰ. 대장암 치료 가이드라인과 내시경 치료 ·············· 2
Ⅱ. 큰 대장 종양의 임상병리학 특징 ················· 4
Ⅲ. 대장 ESD의 적응증 ······················· 6
     1. 대장 ESD 적응증 기준의 제안 6
     2. 대장 ESD 적응증 이유 6
     3. 기술적 어려움을 극복하고 표준화로 가는 길 10
     4. 시술 전 진단 능력 익히기 10


2 장 대장 ESD 시술자의 필요조건

Ⅰ. 안전한 대장 ESD를 위해 시술자에게 요구되는 조건 ········ 20
Ⅱ. 대장 ESD를 시작하는 기술적 조건 ··············· 22
     1. 대장 ESD 기술 습득을 위한 수련 22
     2. 대장 ESD와 수술의 유사점-층을 끝까지 확인하는 것이 중요 24
     3. 위·식도 ESD와 대장 ESD가 서로 다른 점 24
Ⅲ. 안전한 대장 ESD를 위한 시술자의 기술 조건 ··········· 25
     1. 스코프 끝이 흔들리지 않는 내시경 조작 25
     2. 대장 ESD의 시술범위 전개 26
     3. ESD에 사용하는 고주파전원장치, 선단 attachment와 국소주사액 27


3 장 요구되는 시설과 기자재

Ⅰ. 시설 ····························· 30
Ⅱ. 전처치 ···························· 30
Ⅲ. 국소주사액 ························· 31
Ⅳ. ESD용 knife ························· 31
     1. Dual knife 32
     2. Hook knife 32
     3. Needle knife 32
Ⅴ. 지혈 도구 ·························· 33
Ⅵ. 고주파전원장치의 종류·설정 ················· 33
Ⅶ. 내시경 ···························· 34
Ⅷ. 선단 attachment ························ 34
Ⅸ. 송기 ····························· 34


4 장  대장 ESD를 실행할 때의 주의점(위 ESD와의 차이)

Ⅰ. 장기 해부학 특징 ······················· 40
Ⅱ. 치료 전 주의점 ························ 41
     1. 시술 전 준비 41
     2. 내시경 선택 41
     3. Knife 선택 42
Ⅲ. 치료시 주의점 ························ 42
     1. 진정과 내시경 삽입 42
     2. 절개와 박리 43
     3. 고주파전원장치 설정 43
     4. 자세 변환과 중력 활용 44
Ⅳ. 어려울 때 주의점 ······················· 44
     1. 출혈 44
     2. 천공 45


5 장 대장 ESD의 실제

1 대장 ESD에 필요한 동의서 
  Ⅰ. 대장 ESD 관련한 동의서 취득의 핵심 ·············· 48

2 실제 수기 
(1) Dual knife의 기본 수기 ·················· 52
Ⅰ. Dual knife의 특징과 사용법 ·················· 52
Ⅱ. 치료 전략과 요령 ······················· 53
     1. 병변 관찰과 치료 전략 53
     2. 내시경 삽입과 국소주사 54
     3. 절개 요령 54
     4. 박리 요령 55
(2) Hook knife의 기본 수기를 중심으로 ············ 60
Ⅰ. 대장 ESD 시작 전 유의점 ··················· 61
     1. 내시경 조작성 확인 61
     2. 내시경 선택 61
     3. 선단 attachment 61
     4. 고주파전원장치 61
     5. 국소주사액 62
Ⅱ. 접근 전략 ·························· 62
Ⅲ. 실제 수기 ·························· 62
     1. 점막 절개 62
     2. 점막하층 박리 63
     3. 지혈 64
Ⅳ. 치상선에 걸친 종양이나 치핵 위에 있는 종양의 ESD ······ 66
(3) Hook knife의 응용기술 ·················· 74
Ⅰ. Hook knife의 기본 수기-보면서 절개박리 시행 ········· 75
Ⅱ. Hook knife의 응용수기-sweeping 박리 요령 ········· 79
Ⅲ. 난이도가 높은 병변의 ESD 요령 ················ 82
     1. 점막하층에 섬유화를 동반한 병변의 ESD 82
     2. 경미한 섬유화 상태에서 ESD 요령 86
     3. 고도 섬유화 87
     4. 큰 병변의 ESD 88

3 증례별 치료 전략 
(1) SM 경도침윤암의 쉽게 출혈하는 병변  ······ 97
(2) 점막하층에 섬유화가 있는 병변  ········101
(3) 직장 병변 ··················104
(4) 맹장 병변 ·················· 107
(5) S상 결장 병변 DVD menu 9 ················110

4 합병증 대책 
Ⅰ. 천공 ····························· 113
     1. 예방책 114
     2. 기구에 의한 천공 예방 114
     3. 천공 대응책 115
    4. 천공부위가 클립 봉합이 안 될 경우 115
Ⅱ. 복부 compartment 증후군 ·················· 115
Ⅲ. 직장 ESD는 안전한가? ···················· 116
Ⅳ. 출혈 ····························· 116

5 시술 후 관리 
Ⅰ. ESD 시술 후에 발생할 수 있는 주요 합병증과 대책 ········ 118
Ⅱ. 궤양 바닥의 관찰 및 평가 ··················· 119
     1. 출혈 관리 119
     2. 천공 관리 119
Ⅲ. 시술 후 관리의 실제와 요령 ·················· 121
     1. 시술 후 신체검사 121
     2. 혈액 소견 122
     3. 대변 상태 122
     4. 시술 중에 천공이 발생한 경우 123
     5. 외과의사와의 협진 124

6 ESD 표본 취급 
Ⅰ. 표본을 얻기 전에 ······················· 126
Ⅱ. 표본 취급-전시부터 고정까지 ················· 128
Ⅲ. 실체현미경 관찰-염색으로 관찰, 할입까지 ············ 131
     1. 염색 131
      2. 실체현미경 관찰요령 132

Ⅳ. 병리조직 형상의 확인 ····················· 134


INDEX ································ 138



DVD menu 목차

【 대장 ESD의 기본 】

DVD menu 1 Dual knife를 이용한 ESD
- 하행결장에 있는 병변의 ESD 

DVD menu 2 Dual knife와 Hook knife를 이용한 ESD
- 직장 병변의 ESD(혈관이 풍부한 예) 

DVD menu 3 천공 예에서 배우다 
① Hook Knife 끝을 잘못 조작하여 발생한 미세천공
② Hooking할 때 점막하층의 섬유화 때문에 근육층이 들리면서 통전되어 발생한 미세천공

DVD menu 4 Hook knife를 이용한 ESD
- Hook knife의 응용테크닉 

【 증례별 치료 전략 】

DVD menu 5 SM 경도침윤암의 쉽게 출혈하는 병변 

DVD menu 6 점막하층에 섬유화가 있는 병변 

DVD menu 7 직장 병변 

DVD menu 8 맹장 병변 

DVD menu 9 S상 결장 병변