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Endoscopic shielding technique, a new method in therapeutic endoscopy

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World Journal of Gastroenterology 2017年第21期23卷 3761-3764页

作者： Ignacio Bon Ramon Bartolí Vicente Lorenzo-Zúniga Institut Investigació en Ciències de la Salut Germans Trias i Pujol Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas endoscopy Unit Department of GastroenterologyHospital Universitari Germans Trias i Pujol

Prevention of late complications after large endoscopic resection is inefficient with current *** shielding,as a simple and safe technique,has been proposed to improve the incidence of these *** methods,sheets or hydrogels,have showed proven efficacy in the prevention of late bleeding and perforation,as well as the improvement of tissue repair,in experimental models and in clinical practice.

关键词： Endoscopic shielding technique Late complication therapeutic endoscopy

Gastric fundoplication with endoscopic technique:A novel approach for gastroesophageal reflux disease treatment

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World Journal of Gastrointestinal endoscopy 2024年第10期16卷 557-565页

作者： Eyad Gadour Anna Carolina Hoff Department of Gastroenterology and Hepatology King Abdulaziz Hospital-National GuardAhsa 31982Saudi Arabia Internal Medicine Zamzam University CollegeSchool of MedicineKhartoum 11113Sudan Bariatric endoscopy Angioskope ClinicSão Josédos Campos 12243-680São PauloBrazil

BACKGROUND Gastric fundoplication with endoscopic technique(GFET)is an innovative approach to managing gastroesophageal reflux disease(GERD).This minimally invasive procedure utilizes the GEN-2 Apollo endosuture device and Olympus H2T180 gastroscope to perform partial fundoplication by strategically placing Prolene 2-0 sutures at the 11,7,5,1,and 3 o’clock positions around the gastroesophageal *** To evaluate whether GFET enhances the lower esophageal sphincter function by creating comprehensive plication to improve the barrier against *** This single-center prospective study included patients undergoing *** beginning GFET,pH metrics and subsequent manometric measurements were *** analysis of variance was performed to determine statistically significant differences between quality of life(QOL)and DeMeester scores at the time of the procedure and 6 and 12 months ***’sχ2 test was performed to identify statistically significant differences between categorical variables at the time of the procedure and 6 and 12 months *** Eighteen participants were enrolled(11 males and 7 females;mean age,35 years).More than 70%had an initial Hill grade of *** adverse event was recorded after the *** patient underwent valve reinforcement at 12 *** mean QOL score was markedly higher at the time of the procedure(39.9±4.0)compared to those at 6 and 12 months postoperatively(P<0.001).Scores at 12 months were slightly higher than those at 6 *** highest mean QOL score was observed at the time of the procedure,followed by those at 6 and 12 months postoperatively(P<0.001).A similar trend was noted for the mean DeMeester scores(P<0.001).CONCLUSION GFET is a minimally invasive alternative to traditional surgical interventions and endoscopic techniques for managing *** research is warranted to validate its long-term efficacy and effectiveness over existing treatments.

关键词： Gastric fundoplication with endoscopic technique Gastroesophageal reflux disease therapeutic endoscopy

Third-space endoscopy:the final frontier

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Gastroenterology Report 2023年第1期11卷 14-23页

作者： Maham Hayat Dennis Yang Peter V.Draganov Center for Interventional endoscopy AdventHealthOrlandoFLUSA Division of Gastroenterology Hepatologyand NutritionUniversity of FloridaGainesvilleFLUSA

Over the years,our growing experience with endoscopic submucosal dissection along with technological advances has so-lidiﬁed our comfort and knowledge on working in the submucosa,also referred to as the“third space.”Per-oral endoscopic myotomy(POEM)was theﬁrst prototype third-space endoscopy(TSE)procedure,demonstrating the feasibility and clinical utility of endoscopic esophagogastric myotomy via submucosal *** launch of POEM accelerated the evolution of TSE from a vanguard concept to an expandingﬁeld with a wide range of clinical *** this review,we discuss the status and future directions of multiple TSE interventions.

关键词： endoscopy final frontier therapeutic endoscopy third-space endoscopy submucosal endoscopy

Endoscopic management of colorectal polyps

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Gastroenterology Report 2023年第1期11卷 114-122页

作者： Pingting Gao Kaiqian Zhou Wei Su Jia Yu Pinghong Zhou endoscopy Center and endoscopy Research Institute Zhongshan HospitalFudan UniversityShanghaiP.R.China Surgery Department Zhongshan HospitalFudan UniversityShanghaiP.R.China Shanghai Medical College Fudan UniversityShanghaiP.R.China

Colorectal polyps are premalignant lesions in the lower gastrointestinal *** polypectomy is an effective strategy to prevent colorectal cancer morbidity and more invasive *** for the endoscopic resection of polyps keep evolving,and endoscopists are required to perform the most appropriate technique for each *** this review,we outline the evaluation and classification of polyps,update the recommendations for optimal treatment,describe the polypectomy procedures and their strengths/weaknesses,and discuss the promising innovative methods or concepts.

关键词： therapeutic endoscopy polypectomy colorectal polyps colonic lesion

Endoscopic submucosal dissection for gastrointestinal neoplasms

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World Journal of Gastroenterology 2008年第19期14卷 2962-2967页

作者： Naomi Kakushima Mitsuhiro Fujishiro Department of Gastroenterology The University of TokyoGraduate School of Medicine

Endoscopic submucosal dissection (ESD) is an advanced technique of therapeutic endoscopy for superficial gastrointestinal neoplasms. Three steps characterize it:injecting fluid into the submucosa to elevate the lesion, cutting the surrounding mucosa of the lesion, and dissecting the submucosa beneath the lesion. The ESD technique has rapidly permeated in Japan for treatment of early gastric cancer, due to its excellent results of en- bloc resection compared to endoscopic mucosal resection (EMR). Although there is still room for improvement to lessen its technical difficulty, ESD has recently been applied to esophageal and colorectal neoplasms. Favorable short-term results have been reported, but the application of ESD should be well considered by three aspects:(1) the possibility of nodal metastases of the lesion, (2) technical difficulty such as location, ulceration and operator’s skill, and (3) organ characteristics.

关键词： Endoscopic submucosal dissection Gastric cancer Esophageal cancer Colorectal cancer Endoscopic mucosal resection therapeutic endoscopy

Endoscopic submucosal dissection for stomach neoplasms

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World Journal of Gastroenterology 2006年第32期12卷 5108-5112页

作者： Mitsuhiro Fujishiro Department of Gastroenterology Graduate School of Medicine University of Tokyo7-3-1HongoBunkyokuTokyoJapan

Recent advances in techniques of therapeutic endoscopy for stomach neoplasms are rapidly achieved. One of the major topics in this field is endoscopic submucosal dissection （ESD）. ESD is a new endoscopic technique using cutting devices to remove the tumor by the following three steps： injecting fluid into the submucosa to elevate the tumor from the muscle layer, pre-cutting the surrounding mucosa of the tumor, and dissecting the connective tissue of the submucosa beneath the tumor. So the tumors are resectable in an en bloc fashion, regardless of the size, shape, coexisting ulcer, and location. Indication for ESD is strictly confined by two aspects： the possibility of nodal metastases and technical difficulty, which depends on the operators. Although long-term outcome data are still lacking, short-term outcomes of ESD are extremely favourable and laparotomy with gastrectomy is replaced with ESD in some parts of therapeutic strategy for early gastric cancer.

关键词： therapeutic endoscopy Endoscopicsubmucosal dissection Stomach neoplasia Early cancer Node-negative tumor

Alternative uses of lumen apposing metal stents

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World Journal of Gastroenterology 2020年第21期26卷 2715-2728页

作者： Prabin Sharma Thomas R McCarty Ankit Chhoda Antonio Costantino Caroline Loeser Thiruvengadam Muniraj Marvin Ryou Christopher C Thompson Department of Gastroenterology and Hepatology Yale-New Haven Health-Bridgeport HospitalBridgeportCT 06610United States Division of Gastroenterology Hepatology and EndoscopyBrigham and Women’s HospitalHarvard Medical SchoolBostonMA 02115United States Department of Internal Medicine Yale-New Haven Health-Bridgeport HospitalBridgeportCT 06708United States Section of Digestive Diseases Yale University School of MedicineNew HavenCT 06520United States

The advent of lumen apposing metal stents(LAMS)has revolutionized the management of many complex gastroenterological conditions that previously required surgical or radiological *** procedures have garnered popularity due to their minimally invasive nature,higher technical and clinical success rate and lower rate of adverse *** virtue of their unique design,LAMS provide more efficient drainage,serve as conduit for endoscopic access,are associated with lower rates of leakage and are easy to be *** used for drainage of pancreatic fluid collections,the use of LAMS has been extended to gallbladder and biliary drainage,treatment of luminal strictures,creation of gastrointestinal fistulae,pancreaticobiliary drainage,improved access for surgically altered anatomy,and drainage of intra-abdominal and pelvic abscesses as well as post-surgical fluid *** new indications of endosonographic techniques and LAMS continue to evolve,this review summarizes the current role of LAMS in the management of these various complex conditions and also highlights clinical pearls to guide successful placement of LAMS.

关键词： Lumen apposing metal stents Walled off necrosis Gallbladder drainage Biliary drainage Gastric access temporary for endoscopy Gastric outlet obstruction therapeutic endoscopy

Endoscopic ultrasound-guided vascular interventions: Current insights and emerging techniques

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World Journal of Gastroenterology 2021年第40期27卷 6874-6887页

作者： Rupinder Mann Hemant Goyal Abhilash Perisetti Saurabh Chandan Sumant Inamdar Benjamin Tharian Department of Internal Medicine Saint Agnes Medical CenterFresnoCA 93730United States Department of Internal Medicine The Wright Center for Graduate Medical EducationScrantonPA 18503United States Department of Gastroenterology and Hepatology The University of Arkansas for Medical SciencesLittle RockAR 72205United States Department of Gastroenterology and Hepatology CHI Creighton University Medical CenterOmahaNE 68107United States Department of Internal Medicine Gastroenterology and Hepatology DivisionUniversity of Arkansas for Medical SciencesLittle RockAR 72205United States

Endoscopic ultrasound(EUS)is one of the significant breakthroughs in the field of advanced *** the last two decades,EUS has evolved from a diagnostic tool to a real-time therapeutic *** luminal gastrointestinal(GI)tract provides a unique opportunity to access multiple vascular structures,especially in the mediastinum and abdomen,thus permitting a variety of EUS-guided vascular *** addition of the doppler and contrast-enhanced capability to EUS has further helped provide real-time visualization of blood flow in vessels through the GI ***-guided vascular interventions rely on standard endoscopic accessories and interventional tools such as fine-needle aspiration needles and fine-needle *** allows the visualization of various structures in real-time by differentiating tissue densities and vascularity,thus,avoiding radiation ***-guided techniques also allow real-time microscopic examination after target ***,many necessary interventions can be done during the same procedure after *** article provides an overview of EUS-guided vascular interventions such as variceal,non-variceal bleeding interventions,EUSguided portal vein(PV)access with the formation of an intrahepatic portosystemic shunt,and techniques related to diagnosis of GI ***,we discuss current insights and future outlook of therapeutic modalities like PV embolization,PV sampling,angiography,drug administration,and portal pressure measurement.

关键词： Endoscopic ultrasound Vascular intervention Esophageal varices Gastric varices Portal vein therapeutic endoscopy

Role of endoscopy in inflammatory bowel disease

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Gastroenterology Report 2018年第2期6卷 75-82,I0001页

作者： Shishira Bharadwaj Neeraj Narula Parul Tandon Mohammad Yaghoobi Department of Gastroenterology/Hepatology Beth Israel Deaconess Medical Center330 Brookline AveBostonMA 02215USA Division of Gastroenterology McMaster University1280 Main St WHamiltonON L8S 4L8Canada Department of Medicine The Ottawa Hospital501 Smyth RdOttawaON K1H 8L6Canada

Crohn’s disease(CD)and ulcerative colitis(UC)constitute the twomost common phenotypes of inflammatory bowel disease(IBD).Ileocolonoscopy with biopsy has been considered the gold standard for the diagnosis of *** diagnosis of CD and UC is important,as theirmedical and surgical treatmentmodalities and prognoses can be ***,approximately 15%of patients with IBD aremisdiagnosed as IBD unclassified due to the lack of diagnostic certainty of CD or ***,there has been increased recognition of the role of the therapeutic endoscopist in the field of *** imaging techniques have been developed to aid in the differentiation of UC vs ***,endoscopic balloon dilation and stenting have become an integral part of the therapeutic armamentariumof CD *** ultrasound has been recognized as beingmore accurate thanmagnetic resonance imaging in detecting perianal fistulae in patientswith ***,chromoendoscopymay help to detect dysplasia earlier compared with white-light ***,interventional endoscopy has become a cornerstone in the diagnosis,treatment andmanagement of IBD *** role of endoscopy in the field of IBD has significantly evolved in recent years fromsmall-bowel imaging to endoscopic balloon dilation and use of chormoendoscopy in dysplasia *** this reviewarticle,we discuss the current evidence on interventional endoscopy in the diagnosis,treatment andmanagement of IBD compications.

关键词： Inflammatory bowel disease small-bowel imaging therapeutic endoscopy chromoendoscopy endoscopic balloon dilation