胃癌診療 -内視鏡治療と予防の最前線-

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13 Narrow Band Imaging Light Penetration Depth Light penetration depth within the tissue highly depends on the wavelength. Narrowing bandwidth can enhance the differences in the penetration depth between wavelengths.

14 NBI

15 RCT Lancet 2008

16

17 P<0.001 Uemura et al., N Engl J Med 2001

18 (%) 10g 40 6 (15%) 37g 24 8 (33%) 78g 25 9 (36%) 154g 30 19(63%) 10g 27 0 ( 0%) 38g 25 0 ( 0%) 81g 25 1 ( 4%) 165g 27 0 ( 0%) Int J Cancer 2006

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24 6 Asaka et al. Gastroenterology 1992

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29 RCT Lancet 2008

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31 % % P=0.04 (Log rank test)

32 J Gastroenterol 2007; 41: 21-7.

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40 (IIIA,T3N1M0) 5.4 Before eradication After 2 months 1.2 years 2.9 years 5.4 years 2.5 years later

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42 LECS:Laparoscopy and Endoscopy Combined Surgery NOTES Normal Orifice Transluminal Endoscopic Surgery

43

44 LECS:Laparoscopy and Endoscopy Combined Surgery

45 LECS

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