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% […]
Category: Surgical Endoscopy
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 […]
Transforming Gallbladder Drainage for Acute Cholecystitis
Endoscopic ultrasound-guided gallbladder drainage is now more effective than traditional methods for patients unfit for surgery. EUS-guided drainage shows higher technical success rates and better patient outcomes compared to percutaneous methods. Fewer complications and reinterventions are reported with EUS compared to previous techniques. Surgeons should consider EUS for optimal patient selection in non-surgical candidates, balancing […]
Preoperative Biliary Drainage with Metal Stents Safe in Pancreatic Cancer
Preoperative biliary drainage (PBD) using self-expanding metal stents (SEMS) is noninferior to early surgery for pancreatic cancer patients, impacting surgical timing decisions. Serious adverse events were similar: 29.0% in PBD vs. 26.5% in early surgery (p = 0.011 for noninferiority). 82.6% of PBD patients had curative surgery versus 88.5% in the early surgery group. Surgeons […]
New Biliary Drainage Technique for Altered Anatomy Shows Promise
A novel endoscopic approach improves biliary drainage outcomes for patients with altered anatomy. Technical success rate: 87.3%, clinical success: 93.8%. Adverse event rate: 20%, with 30.6% persistent fistula rate within 3 months. Consider this technique for patients with complex anatomy, especially when multiple biliary interventions are needed. Most common indication: benign strictures (58.2%). Multicenter Study […]
EUS-RFA Offers Safe Option for Intraductal Neoplasms
EUS-guided radiofrequency ablation is a safe alternative for patients with branch-duct IPMNs showing worrisome features who cannot undergo surgery. Technical success was 100% in 62 procedures, with 98% achieving local control. Adverse events occurred in 27%, primarily mild abdominal pain; no deaths reported. This procedure effectively prevents cancer progression in patients unsuitable for traditional surgery. […]
Long-term Insights on ESD for T1 Colorectal Cancer
Endoscopic submucosal dissection offers effective long-term outcomes for T1 colorectal cancer, but high-risk patients may benefit from additional surgery. In a study of 383 T1 CRC patients, the 5-year local recurrence rate was 6.8% in high-risk follow-up patients vs. 0% in those who had surgery (p<0.001). Overall survival at 5 years was significantly lower for […]