Laparoscopic hiatal hernia repair combined with consecutive transoral incisionless fundoplication (cTIF) achieves high success rates in GERD patients. 92% of patients achieved complete clinical success within 12 months. Symptom improvement was reported by 90% and 84% normalized esophageal acid exposure. Most patients (84%) stopped daily proton pump inhibitors, enhancing long-term management potential for surgeons. Serious […]
Category: Surgical Endoscopy
Colonic obstruction management redefined: SEMS trumps surgery.
Using self-expanding metal stents (SEMS) as bridge-to-surgery improved outcomes for obstructive left colon cancer. One-year stoma rates were lower with SEMS (44.4%) compared to emergency surgery (73.4%). Fewer readmissions (4.2% vs 15.9%) and faster chemotherapy initiation (76.1% vs 55.8%) were noted with SEMS. Consider SEMS for selected patients to reduce stoma rates and enhance quality […]
Endoscopic ultrasound-drained gallbladders safe in perforation
Surgeons can safely use endoscopic ultrasound-guided gallbladder drainage in patients with inoperable acute cholecystitis and Niemeier type II perforation. Technical success was 100% in 14 patients treated with electrocautery-enhanced stents. Clinical success reached 92.9% with only mild adverse events, and no severe complications after a median follow-up of 315 days. Consider this approach in high-risk […]
POEM and LHD show similar long-term outcomes for achalasia.
At 5 years, 87.3% of POEM and 90.1% of LHD patients had an Eckardt score ≤3. POEM patients had a higher need for PPIs (45.6% vs 24.6%) and increased rates of esophagitis (34% vs 10.4%). Surgeons should consider the higher GERD incidence with POEM when selecting treatment. Symptomatic recurrence at 5 years was low in […]
Standardized Endoscopy Could Improve Gastric Cancer Outcomes
Diagnostic endoscopy for gastric cancer is underused, leading to late-stage diagnoses and worse survival rates. 73% of stage I gastric cancer patients are symptomatic, yet many are diagnosed late. Median overall survival varies drastically: 47 months for stage II versus 11 months for stage IV. Surgeons should advocate for standardized endoscopy protocols to improve early […]
Endoscopic dissection proves effective for early esophageal cancer
Endoscopic submucosal dissection (ESD) can be a viable option for patients with esophageal squamous high-grade dysplasia and early squamous cell carcinoma, challenging the conventional referral for surgical intervention. Curative resection rates were significantly higher for absolute criteria lesions at 71.8%, compared to just 19.4% for outside criteria lesions. Of the outside criteria group, nearly 20% […]
Endoscopic and Surgical Advances in Achalasia Treatment
Minimally invasive strategies are transforming achalasia management. Laparoscopic myotomy, POEM, and emerging techniques like peroral oesophageal plication show promising outcomes. Individualized treatment based on high-resolution manometry, patient co-morbidities, and procedural risks is now essential. Comprehensive treatment offers significant symptom relief and quality-of-life improvement. Addressing post-treatment reflux and surveillance for malignancy remains critical for long-term patient […]
Advancements in Achalasia Treatment Enhance Outcomes
New strategies in achalasia management are improving surgical and endoscopic outcomes for better patient care. Minimally invasive techniques like robotic myotomy and POEM have significant advantages over traditional methods. Treatment can now be tailored based on manometric subtype, esophageal structure, and patient health, increasing success rates. Surgeons should prioritize individualized treatment plans to enhance patient […]
Long-term Outcomes of Endoscopic Submucosal Dissection in T1 CRC
Endoscopic submucosal dissection (ESD) offers compelling insights into managing T1 colorectal cancer (CRC), shaping surgical strategies. Of 383 T1 CRC patients, 3.6% had recurrences and 1.8% died in the high-risk group; none occurred in low-risk patients. In high-risk cases, local recurrence was 6.8% without surgery versus 0% with surgery (p < .001). Consider ESD alone […]
Endoscopic Therapy in Chronic Pancreatitis: Key Insights
Targeted endoscopic approaches offer symptom relief in chronic pancreatitis but surgery is preferred for long-term outcomes. Endoscopy is effective for small pancreatic duct stones; larger stones require extracorporeal shock wave lithotripsy or pancreatoscopy. Main pancreatic duct strictures should be treated with dilation and single large-caliber plastic stents; avoid fully covered metal stents due to higher […]