抄録
We designed a new marking clip forr the esophagus and performed esophageal marking using the clip under the observation with the fiberscope. After we ascertained the safety, utility and durability of the apparatus in animal experiments, we applied the clip mainly to the patient with esophageal cancer. The preoperative irradiation field of the patient with esophageal cancer is decided by the basis of the supine projection of the esophagus; however, in the infiltrative or intracanaricular spreading cases, there are at times difficulties in deciding the irradiation field. The investigation revealed that 40% of patients were given inadequate fields. Presently we can obtain sufficient irradiation field by using the clip attached to the circumference of the cancer. We performed clipping again immediately before the operation and this clip is of help to decide the resection line since the clip is palpable during the operation. Furthermore, the clip plays the role of an indicator while performing mediastinoscopy and angiography, and it has an advantage of judging the lesion in three dimensions. We performed the clipping in a total of 52 times, using 70 clips. Neither complaints nor complications were observed. The clip remained on the esophageal wall for about 2 weeks. The characteristics of our clip are as follows: 1. Technically, the clip can be applied by as simple as a biopsy technique. 2. It is possible to make clear markings and is easy to identity. 3. The duration of the retainment of the clip is about 2 weeks and is long enough to observe the lesion. 4. No patient complained and complications were observed. 5. The clip may fall off into the internal cavity but it is not absorbed. Our clip method compensates for the weak point of the marking method which was designed by Palmar and Endo.
