インドシアニングリーンを用いた食道静脈瘤の半導体レーザー治療

点击翻译按钮获取中文摘要

Endoscopic sclerotherapy and variceal ligation are widely accepted as the first choice of treatment for esophageal varices. However, its safety and efficacy has not been completely achieved yet.We developped ICG enhanced diode laser photosclerotherapy as preventive treatment for bleeding esophageal varices. Submucosal injection of wave length-specific dye (ICG : indocyanine green) could provide enhanced diode laser beam absorbtion selectively in the submucosal tissues around esophageal varices. First of all, we clarified the efficacy and safety of this new technique esperimentally using dog's esophagus and then applied it in 6 cases of esophageal varices. In the experimentally study, thermal injuries in the mucosa and submucosa were selectively induced without surface defects during irradiation. A month follow up e*oscopy showed degenerated mucosa and submucosa to be replaced with fibrosis while no changes were observed in the muscle layer. Based on these findings, we therefore, applied this technique in 6 patients of esophageal varices after EVL treatment. Complete eradication was archieved within 2 weeks in all cases. A mild stenosis was seen in 2 patients, which was easily treated by balloon dilatation. It is concluded that ICG dye enhanced diode laser photosclerotherapy would be useful as a simple, safe and effective alternative to prevent bleeding from esophageal varices.