scholarly journals Comparison of Endoscopic Techniques in the Management of Type I Gastric Neuroendocrine Neoplasia: A Systematic Review

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Francesco Panzuto ◽  
Ludovica Magi ◽  
Gianluca Esposito ◽  
Maria Rinzivillo ◽  
Bruno Annibale
Keyword(s):  
Systematic Review ◽  
Endoscopic Resection ◽  
Final Analysis ◽  
En Bloc Resection ◽  
Endoscopic Technique ◽  
Endoscopic Management ◽  
Type I ◽  
En Bloc ◽  
Endoscopic Techniques ◽  
Neuroendocrine Neoplasia

Background. Endoscopic resection is considered the treatment of choice for type I gastric neuroendocrine neoplasia (gNEN) given its indolent behaviour; however, the favoured endoscopic technique to remove these tumours is not well established. Aims. This systematic review is aimed at investigating the best endoscopic management for type I gNEN. Methods. PubMed Central/Medline and Scopus were systematically searched for records up to August 31, 2020. Results. After screening the 675 retrieved records, 6 studies were selected for the final analysis. The main endoscopic resection techniques described were endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). Overall, 112 gNENs were removed by EMR and 77 by ESD. Both techniques showed similar results for complete and en bloc resection (97.4% and 98.7%; 92.3% and 96.3% with ESD and EMR, respectively). ESD was associated with a higher rate of complications than EMR (11.7% vs. 5.4%), but this difference was not statistically significant ( p = 0.17 ). The rates of recurrence during follow-up were 18.2% and 11.5% for EMR and ESD, respectively. Conclusions. To date, there are no sufficient data showing superiority of a given endoscopic technique over others. Both ESD and EMR seem to be effective in the management of type I gNEN, with a relatively low rate of recurrence.

scholarly journals Endoscopic management of superficial nonampullary duodenal tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

Endoscopy ◽  
2021 ◽  
Author(s):  
Geoffroy Vanbiervliet ◽  
Alan Moss ◽  
Marianna Arvanitakis ◽  
Urban Arnelo ◽  
Torsten Beyna ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
En Bloc Resection ◽  
Endoscopic Management ◽  
Duodenal Adenoma ◽  
En Bloc ◽  
Strong Recommendation ◽  
Delayed Bleeding ◽  
Duodenal Adenomas ◽  
Moderate Quality ◽  
Quality Evidence

Main recommendations 1 ESGE recommends that all duodenal adenomas should be considered for endoscopic resection as progression to invasive carcinoma is highly likely.Strong recommendation, low quality evidence. 2 ESGE recommends performance of a colonoscopy, if that has not yet been done, in cases of duodenal adenoma.Strong recommendation, low quality evidence. 3 ESGE recommends the use of the cap-assisted method when the location of the minor and/or major papilla and their relationship to a duodenal adenoma is not clearly established during forward-viewing endoscopy.Strong recommendation, moderate quality evidence. 4 ESGE recommends the routine use of a side-viewing endoscope when a laterally spreading adenoma with extension to the minor and/or major papilla is suspected.Strong recommendation, low quality evidence. 5 ESGE suggests cold snare polypectomy for small (< 6 mm in size) nonmalignant duodenal adenomas.Weak recommendation, low quality evidence. 6 ESGE recommends endoscopic mucosal resection (EMR) as the first-line endoscopic resection technique for nonmalignant large nonampullary duodenal adenomas.Strong recommendation, moderate quality evidence. 7 ESGE recommends that endoscopic submucosal dissection (ESD) for duodenal adenomas is an effective resection technique only in expert hands.Strong recommendation, low quality evidence. 8 ESGE recommends using techniques that minimize adverse events such as immediate or delayed bleeding or perforation. These may include piecemeal resection, defect closure techniques, noncontact hemostasis, and other emerging techniques, and these should be considered on a case-by-case basis.Strong recommendation, low quality evidence. 9 ESGE recommends endoscopic surveillance 3 months after the index treatment. In cases of no recurrence, a further follow-up endoscopy should be done 1 year later. Thereafter, surveillance intervals should be adapted to the lesion site, en bloc resection status, and initial histological result. Strong recommendation, low quality evidence.

scholarly journals Clinical Overview of GIST and Its Latest Management by Endoscopic Resection in Upper GI: A Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Cicilia Marcella ◽  
Rui Hua Shi ◽  
Shakeel Sarwar
Keyword(s):  
Endoscopic Resection ◽  
Gastrointestinal Stromal Tumors ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Endoscopic Techniques ◽  
Stromal Tumors ◽  
Upper Gi ◽  
Risk Of Malignancy

Aims. To review the clinical presentation, diagnosis, assessment of risk of malignancy, and recent advances in management (mainly focusing on the role of endoscopic resection) of gastrointestinal stromal tumors (GISTs) in upper GI.Method. We searched Embase, Web of science, and PubMed databases from 1993 to 2018 by using the following keywords: “gastrointestinal stromal tumors,” “GIST,” “treatment,” and “diagnosis.” Additional papers were searched manually from references of the related articles.Findings. The improvement of endoscopic techniques in treating upper gastrointestinal subepithelial tumors especially gastrointestinal tumors has reduced the need for invasive surgery in patients unfit for surgery. Many studies have concluded that modified endoscopic treatments are effective and safe. These treatments permit minimal tissue resection, better dissection control, and high rates of en bloc resection with an acceptable rate of complications.

Endoscopic Resection of Type I Gastric Neuroendocrine Neoplasia: A Systematic Review

2021 ◽  
Author(s):  
G Esposito ◽  
F Panzuto ◽  
L Magi ◽  
M Rinzivillo ◽  
B Annibale
Keyword(s):  
Systematic Review ◽  
Endoscopic Resection ◽  
Type I ◽  
Neuroendocrine Neoplasia

scholarly journals Prevention and Management of Complications and Education in Endoscopic Submucosal Dissection

2021 ◽  
Vol 10 (11) ◽  
pp. 2511
Author(s):  
Yoshitsugu Misumi ◽  
Kouichi Nonaka
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Endoscopic Mucosal Resection ◽  
Endoscopic Resection ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Resection Rate ◽  
En Bloc ◽  
Educational Methods ◽  
Submucosal Dissection ◽  
Management Of Complications

Endoscopic submucosal dissection (ESD) is considered superior to endoscopic mucosal resection as an endoscopic resection because of its higher en bloc resection rate, but it is more difficult to perform. As ESD techniques have become more common, and the range of treatment by ESD has expanded, the number of possible complications has also increased, and endoscopists need to manage them. In this report, we will review the management of critical complications, such as hemorrhage, perforation, and stenosis, and we will also discuss educational methods for acquiring and improving ESD skills.

scholarly journals Endoscopic Submucosal Dissection for Visible Dysplasia Treatment in Ulcerative Colitis Patients: Cases Series and Systematic Review of Literature

2020 ◽  
Author(s):  
Raffaele Manta ◽  
Angelo Zullo ◽  
Donato Alessandro Telesca ◽  
Danilo Castellani ◽  
Ugo Germani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ulcerative Colitis ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
R0 Resection ◽  
Resection Rate ◽  
En Bloc ◽  
Pooled Data ◽  
Non Invasive ◽  
Neoplastic Lesions

Abstract Background and Aims Ulcerative colitis [UC] patients are at an increased risk of developing colorectal cancer due to chronic inflammation. Endoscopic submucosal dissection [ESD] allows removal of non-invasive neoplastic lesions in the colon, but few data are available on its efficacy in UC patients. Methods Data from consecutive UC patients diagnosed with visible dysplastic lesions in the colon who underwent ESD were evaluated. The en bloc removal, R0 resection and complication rates were calculated. Local recurrence and metachronous lesions during follow-up were identified. A systematic review of the literature with pooled data analysis was performed. Results A total of 53 UC patients [age: 65 years; range 30–74; M/F: 31/22] underwent ESD. The en bloc resection rate was 100%, and the R0 resection rate was 96.2%. Bleeding occurred in seven [13.2%] patients, and perforation in three [5.6%] cases, all treated at endoscopy. No recurrence was observed, but two metachronous lesions were detected. Data from six other studies [three Asian and three European] were available. By pooling data, en bloc resection was successful in 88.4% (95% confidence interval [CI] = 83.5–92) of 216 lesions and in 91.8% [95% CI = 87.3–94.8] of 208 patients. R0 resection was achieved in 169 ESDs, equivalent to a 78.2% [95% CI = 72.3–83.2] rate for lesions and 81.3% [95% CI = 75.4–86] rate for patients. No difference between European and Asian series was noted. Conclusions This pooled data analysis indicated that ESD is a suitable tool for safely and properly removing non-invasive neoplastic lesions on colonic mucosa of selected UC patients.

scholarly journals Endoscopic Submucosal Dissection of Papillary Gastric Adenocarcinoma; Systematic Review

2020 ◽  
Vol 9 (5) ◽  
pp. 1465
Author(s):  
Chang Seok Bang ◽  
Jae Jun Lee ◽  
Gwang Ho Baik
Keyword(s):  
Systematic Review ◽  
Endoscopic Submucosal Dissection ◽  
Curative Resection ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Complete Resection ◽  
Submucosal Invasion ◽  
High Rate ◽  
En Bloc ◽  
Submucosal Dissection

This study evaluated the possibility of endoscopic submucosal dissection (ESD) for early gastric cancer with papillary adenocarcinoma (EGC-PAC). PAC, an uncommon pathologic type of stomach cancer, is classified into differentiated-type histology. However, aggressive features, including a high rate of submucosal invasion, lymphovascular invasion (LVI), and lymph node metastasis (LNM), have been reported in studies with surgical specimens. Treatment outcomes of ESD for EGC-PAC have not been precisely demonstrated. Core databases were sought for the following inclusion criteria: studies of endoscopic resection or surgery of EGC-PAC presenting the following therapeutic indicators; en bloc resection, complete resection, curative resection, recurrence, complications associated with procedures, LVI, or LNM that enabled an analysis of ESD possibility. Overall, 15 studies were included for systematic review. Frequent submucosal invasion and high LVI were noted in EGC-PAC. However, PAC was not significantly associated with LNM. Pooled en bloc resection, complete resection, and curative resection rates were 89.7% (95% confidence interval: 55.3%–98.4%), 85.3% (67.7%–94.2%), and 67% (43%–84.5%), respectively. No LNM was observed if EGC-PAC satisfied the curative resection criteria. ESD seems technically feasible, although a high LVI rate results in a lower rate of curative resection.

Endoscopic resection of low grade, subglottic chondrosarcoma

2009 ◽  
Vol 123 (12) ◽  
pp. 1364-1366 ◽  
Author(s):  
Y Oestreicher-Kedem ◽  
T G Dray ◽  
E J Damrose
Keyword(s):  
Endoscopic Resection ◽  
Cricoid Cartilage ◽  
Voice Quality ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Low Grade ◽  
Retrospective Case ◽  
En Bloc ◽  
Extensive Resection ◽  
Airway Patency

AbstractIntroduction:This paper evaluates the feasibility of transoral, endoscopic resection of macroscopically localised, low grade, subglottic chondrosarcoma.Method:Retrospective case study including patients diagnosed with low grade, subglottic laryngeal chondrosarcoma. Tumours were resected endoscopically via direct laryngoscopy with microlaryngeal technique, under jet ventilation. The post-operative course, vocal fold function, airway patency and oncological results were evaluated.Results:Two male patients aged 49 and 60 years underwent endoscopic, translaryngeal, en bloc resection of low grade chondrosarcoma of the cricoid cartilage. Extubation was performed immediately after surgery. Neither patient required tracheostomy or developed subglottic stenosis. No tumour recurrence was noted after an average follow up of 10.5 months. Voice quality was stable and dyspnoea improved.Summary:Transoral, endoscopic resection of low grade, subglottic chondrosarcoma is a viable technique with good functional outcomes. Extensive resection of subglottic disease is possible, which may afford patients an alternative to total laryngectomy.

scholarly journals Improved endoscopic resection of large flat lesions and early cancers using an external additional working channel (AWC): a case series

2019 ◽  
Vol 07 (02) ◽  
pp. E298-E301 ◽  
Author(s):  
Benjamin Walter ◽  
Simone Schmidbaur ◽  
Yannick Krieger ◽  
Alexander Meining
Keyword(s):  
Gastrointestinal Tract ◽  
Endoscopic Resection ◽  
Case Series ◽  
En Bloc Resection ◽  
Lower Gastrointestinal Tract ◽  
En Bloc ◽  
Dual Channel ◽  
Arterial Bleeding ◽  
Flat Lesions ◽  
Bimanual Tasks

Abstract Background En-bloc resection of large, flat lesions or early stages of cancer is challenging. No bimanual tasks are possible using standard endoscopes. Dual-channel endoscopes are not available everywhere and have a small distance between the channels. Patients and methods A new external additional working channel (AWC) (Ovesco, Tuebingen, Germany) was designed and developed potentially enabling bimanual tasks. Fixed to the tip of a standard gastroscope or pediatric colonoscope, a second endoscopic tool can be inserted through the AWC and used for tissue retraction during endoscopic resection. Results In the upper and lower gastrointestinal tract, endoscopic mucosal resection (EMR) with a modified grasp-and-snare technique and endoscopic submucosal dissection (ESD) were performed successfully using the AWC in eight patients. Complications were acute arterial bleeding post-EMR in two cases treated by endoscopic clipping. Conclusions We conclude that a newly developed external additional working channel (AWC) enables endoscopic resection of large lesions in the upper and lower gastrointestinal tract. Potential benefits are its suitability for EMR and ESD, no need for a dual-channel endoscope and an adjustable distance of working channels.

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