Novel Diagnostic Biomarkers in Colorectal Cancer

Colorectal cancer (CRC) is still a leading cause of cancer death worldwide. Less than half of cases are diagnosed when the cancer is locally advanced. CRC is a heterogenous disease associated with a number of genetic or somatic mutations. Diagnostic markers are used for risk stratification and early detection, which might prolong overall survival. Nowadays, the widespread use of semi-invasive endoscopic methods and feacal blood tests characterised by suboptimal accuracy of diagnostic results has led to the detection of cases at later stages. New molecular noninvasive tests based on the detection of CRC alterations seem to be more sensitive and specific then the current methods. Therefore, research aiming at identifying molecular markers, such as DNA, RNA and proteins, would improve survival rates and contribute to the development of personalized medicine. The identification of “ideal” diagnostic biomarkers, having high sensitivity and specificity, being safe, cheap and easy to measure, remains a challenge. The purpose of this review is to discuss recent advances in novel diagnostic biomarkers for tumor tissue, blood and stool samples in CRC patients.

Global Impact of COVID-19 on Colorectal Cancer Screening: Current Insights and Future Directions

The coronavirus disease 2019 (COVID-19) pandemic has brought significant challenges to many aspects of healthcare delivery since the first reported case in early December 2019. Once in the body, SARS-CoV-2 can spread to other digestive organs, such as the liver, because of the presence of ACE2 receptors. Colorectal cancer (CRC) remains the second-leading cause of death in the United States (US). Therefore, individuals are routinely screened using either endoscopic methods (i.e., flexible sigmoidoscopy and colonoscopy) or stool-based tests, as per the published guidelines. At the beginning of the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) recommended that all non-urgent surgical and medical procedures, including screening colonoscopies, be delayed until the pandemic stabilization. This article aims to review the impact of COVID-19 on CRC screening.

The value of endoscopic examination methods in infertile marriage

To optimize the management of infertile women the estimation of efficacy of endoscopic methods of treatment (laparoscopy and hysteroscopy) in this category of patients was undertaken. With the method of retrospective analysis clinico- laboratory and endoscopic examination of2785 sterile pairs was carried out. The results of the study showed that endoscopic methods are not only the most important stage of diagnostics but also the first pathogenetically substantiated stage in treating female infertility. It became clear that half of the patients demonstrated from 2 till 5 factors in pathogenesis of reproductive function abnormalities that brings on the necessity of elaboratingthe algorithm of treatingparticular patients considering the disturbances revealed.So, to increase the effectiveness of treating the patients in question, distinct standards of medical care should be put into practice.

Endoscopic surgery in gynecology: state and development prospects

In the clinical lecture the main principles of arranging endovideosurgical carein gynecology are substantiated on the basis of the material of 17,5 thousandslaparoscopies and 10 thousands hysteroscopies. The detailed analysis of possibilities of endoscopic methods in operative gynecology is given. The peculiarities of laparoscopys application are depicted in cases of tube-peritoneal infertility, uterine and ovarian tumors, pyoinflammatory diseases of uterine adnexa, ectopic pregnancy, maldevelopment of female genital organs, stress incontinence in women. Perspectives of endovideosurgical technologies in gynecological practice are also shown.

Clinical variants of esophageal stenosis caused by infectious esophagitis in children

Infectious esophagitis (IE) is commonly seen in immunocompromised patients. IE may be the first symptom of immunodeficiency state, also can be complication of immunosuppressive therapy in patients with hematological and oncological diseases. Severe complication of IE is esophageal stenosis. Patient management tactics continue to be discussed. A purpose of our publication is to demonstrate our experience in the management of patients with infectious esophageal stenosis. The etiology, features of the clinical and endoscopic picture, as well as the effectiveness of drug therapy and endoscopic methods of treatment have been analyzed. The study was approved by the Independent Ethics Committee and the Scientific Council of the D. Rogachev NMRCPHOI. In each case, parents gave their consent to the use of their child’s data, including photographs, for research purposes and in publications.

ENDOSCOPIC TREATMENT OF HEREDITARY PANCREATITIS IN A CHILD WITH JUVENILE IDIOPATHIC ARTHRITIS: CLINICAL CASE REPORT AND LITERATURE REVIEW

The severe course of chronic pancreatitis (CP) in children is rare. More often it is caused by hereditary factors and abnormalities of the bile and pancreatic ducts. Cases of the development of pancreatitis against the background of systemic inflammatory diseases are described. Therapy of a systemic disease can aggravate the course of pancreatitis, and the general serious condition of the patient does not allow for the necessary surgical treatment. The article describes the clinical case report of a complicated course of CP against the background of juvenile idiopathic arthritis in a 17-year-old girl. The effectiveness of intraluminal endoscopic methods of treatment (wirsungotomy and stenting of the main pancreatic duct) for relieving exacerbation and complications of CP has been demonstrated.

Quality of life of patients after inguinal hernioplasty by endoscopic methods

A comparative analysis of the indicators of 53 men who underwent inguinal hernioplasty using the TEP (n = 20) and TAPP (n = 33) methods was carried out. Quality of life was assessed using the international questionnaire EQ-5D on the 1st day, 1 month and 12 months after surgery. Monitoring of quality of life parameters showed differences in the assessment of their condition by patients who underwent TEP and TAPP, which were most pronounced on the first day after surgery. The presence of problems during this period for all components of the EQ-5D questionnaire, to a greater extent, was associated by patients with pain / discomfort in the operation area. The latter were maximally manifested in the majority of those who underwent TAPP (64%), which also affected their lower assessment of their health status. The revealed differences disappear within a month after the interventions and are absent 12 months after the operation. Key words: quality of life, inguinal hernioplasty, endoscopic methods.

Hereditary hemorrhagic telangiectasia diagnosed by enteroscopy: a case report

Hereditary hemorrhagic telangiectasia (HHT) is a very rare autosomal dominant multisystemic disease. Patients with this disease usually present with punctate mucocutaneous telangiectasias and arteriovenous malformations. The diagnostic criteria currently in use are the Curaçao criteria. HHT is considered a clinical diagnosis; thus, no imaging or preclinical laboratory is mandatory, and diagnosis and management are performed according to the experience of the treating team. We herein describe a 58-year-old man with no significant medical history who presented with a 15-day history of intermittent hematochezia. He was admitted to the hospital and underwent a series of laboratory tests, including colonoscopy, which showed normal results. Therefore, the patient was discharged with a diagnosis of gastrointestinal bleeding. During his second visit to the emergency room, the doctors requested video capsule endoscopy because of the patient’s history, and a diagnosis of HHT was made. The entire approach and treatment were completed with antegrade double-balloon enteroscopy. This case highlights the importance of endoscopic methods for timely diagnosis and proper management.

Endoscopic Treatment of Obesity and Nutritional Aspects of Bariatric Endoscopy

Obesity is a significant problem worldwide. Several serious diseases that decrease patient quality of life and increase mortality (high blood pressure, dyslipidaemia, type 2 diabetes etc.) are associated with obesity. Obesity treatment is a multidisciplinary and complex process that requires maximum patient compliance. Change of lifestyle is fundamental in the treatment of obesity. While pharmacotherapeutic options are available, their efficacy is limited. Surgical treatment though highly effective, carries the risk of complications and is thus indicated mostly in advanced stages of obesity. Endoscopic treatments of obesity are less invasive than surgical options, and are associated with fewer complications and nutritional deficits. Currently, there is a large spectrum of endoscopic methods based on the principles of gastric volume reduction, size restriction and gastric or small bowel bypass being explored with only few available in routine practice. The aim of this publication is to present an up-to-date summary of available endoscopic methods for the treatment of obesity focusing on their efficacy, safety and nutritional aspects.

Endoscopic decompression for the treatment of lumbar spinal stenosis: an updated systematic review and meta-analysis

OBJECTIVE Lumbar stenosis treatment has evolved with the introduction of minimally invasive surgery (MIS) techniques. Endoscopic methods take the concepts applied to MIS a step further, with multiple studies showing that endoscopic techniques have outcomes that are similar to those of more traditional approaches. The aim of this study was to perform an updated meta-analysis and systematic review of studies comparing the outcomes between endoscopic (uni- and biportal) and microscopic techniques for the treatment of lumbar stenosis. METHODS Following PRISMA guidelines, a systematic search was performed using the Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Ovid Embase, and PubMed databases from their dates of inception to December 14, 2020. All identified articles were then systematically screened against the following inclusion criteria: 1) studies comparing endoscopic (either uniportal or biportal) with minimally invasive approaches, 2) patient age ≥ 18 years, and 3) diagnosis of lumbar spinal stenosis. Bias was assessed using quality assessment criteria and funnel plots. Meta-analysis using a random-effects model was used to synthesize the metadata. RESULTS From a total of 470 studies, 14 underwent full-text assessment. Of these 14 studies, 13 comparative studies were included for quantitative analysis, totaling 1406 procedures satisfying all criteria for selection. Regarding postoperative back pain, 9 studies showed that endoscopic methods resulted in significantly lower pain scores compared with MIS (mean difference [MD] −1.0, 95% CI −1.6 to −0.4, p < 0.01). The length of stay data were reported by 7 studies, with endoscopic methods associated with a significantly shorter length of stay versus the MIS technique (MD −2.1 days, 95% CI −2.7 to −1.4, p < 0.01). There was no significant difference with respect to leg visual analog scale scores, Oswestry Disability Index scores, blood loss, surgical time, and complications, and there were not any significant quality or bias concerns. CONCLUSIONS Both endoscopic and MIS techniques are safe and effective methods for treating patients with symptomatic lumbar stenosis. Patients who undergo endoscopic surgery seem to report less postoperative low-back pain and significantly reduced hospital stay with a trend toward less perioperative blood loss. Future large prospective randomized trials are needed to confirm the findings in this study.