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New uses for endoscopy
April 04, 2006Braquitherapy guided by ecoendoscopy has enabled a therapeutic approach to injuries, hitherto inaccessible by other means.
Braquitherapy involves the local administration of radiotherapy by means of the implantation of radioactive seeds. It involves a technique used in treatment for cancer of the prostate gland, uterus, bronchial tubes and other locations. The technique developed at the University of Navarra University Clinic enables access to tumorous lesions in the area along the digestive tract. Some of these damaged tissues are in areas difficult to access percutaneously or even through surgery. Thanks to the development of ecoendoscopy, we can gain access to many locations from the oesophagus, the stomach, the duodenum or the colon - without affecting the vital organs.
To date the University of Navarra University Clinic has dealt with two cases, both with good results. The treatment involves a low-invasive procedure that opens new therapeutic perspectives for many lesions that otherwise would not have effective treatment.
Reflux treatment
The second application involves the endoscopic fundoplication for the treatment of the gastroesophagael reflux. To date the endoscopic techniques have not enabled a transmural suture to be effected (i.e. one that completely penetrates the digestive wall), and so the sutures disappeared only after three or four years.
Recently, in the United States, this first transmural technique was about to be applied but with the limitation of a maximum of two sutures. However, with the advance in medical engineering, an endoscopic transmural suture has been developed that enables 10 or 12 sutures to be carried out. Unlike conventional procedures, known as fundoplication surgery, this technique has the advantage of gaining access to the lesion via the mouth, without the need for surgery.
To date the most effective gastroesophagael reflux treatment has been with surgery although, according to prestigious publications, after ten years up to 50-60% of the patients need medical treatment again. The endoscopic transmural suture can offer the same results as surgery but with less complications, cost and aggression that a surgical operation involves.
Treatment of obesity
Another novelty with the endoscopic approach is as an alternative to surgery for obesity. Surgical operation is the treatment of choice by patients suffering from morbid obesity. However, it has to be remembered that this is complex and aggressive, with a significant risk factor involved.
There are a number of endoscopic techniques: some aim to reduce the size of the stomach, thus provoking the sensation of satiation; others involve communicating part of the stomach with a distal zone of the small intestine, resulting in less absorption of nutrients.
Elhuyar Fundazioa
Reflux treatment
The second application involves the endoscopic fundoplication for the treatment of the gastroesophagael reflux. To date the endoscopic techniques have not enabled a transmural suture to be effected (i.e. one that completely penetrates the digestive wall), and so the sutures disappeared only after three or four years.
Recently, in the United States, this first transmural technique was about to be applied but with the limitation of a maximum of two sutures. However, with the advance in medical engineering, an endoscopic transmural suture has been developed that enables 10 or 12 sutures to be carried out. Unlike conventional procedures, known as fundoplication surgery, this technique has the advantage of gaining access to the lesion via the mouth, without the need for surgery.
To date the most effective gastroesophagael reflux treatment has been with surgery although, according to prestigious publications, after ten years up to 50-60% of the patients need medical treatment again. The endoscopic transmural suture can offer the same results as surgery but with less complications, cost and aggression that a surgical operation involves.
Treatment of obesity
Another novelty with the endoscopic approach is as an alternative to surgery for obesity. Surgical operation is the treatment of choice by patients suffering from morbid obesity. However, it has to be remembered that this is complex and aggressive, with a significant risk factor involved.
There are a number of endoscopic techniques: some aim to reduce the size of the stomach, thus provoking the sensation of satiation; others involve communicating part of the stomach with a distal zone of the small intestine, resulting in less absorption of nutrients.
Elhuyar Fundazioa
Endoscopy Current Events and Endoscopy News RSSMinimally Invasive Surgery Shown Safe and Effective Treatment for Rectal Cancer
Laparoscopic surgery has been used in the treatment of intestinal disorders for close to 20 years, but its benefits have only recently begun to be extended to people with rectal cancer.
Gastroenterology/hepatology societies release report evaluating fellowship training curriculum
Due to the increasing complexities of treating digestive diseases, allowing gastroenterological (GI) trainee physicians the opportunity to develop enhanced abilities and experiences in specific disease areas or procedures will be a great benefit to patients, according to a "Report of the Multisociety Task Force on GI Training."
Study shows unsedated colonoscopy for colorectal cancer screening well accepted by patients
Researchers from Taiwan report in a new study that unsedated colonoscopy for primary colorectal cancer screening is well accepted in a majority of patients.
Mayo Clinic study shows people with heart devices can 'digest' advanced diagnostic technology safely
A new Mayo Clinic study suggests that video capsule endoscopy (CE), a procedure that uses wireless technology in diagnosing intestinal disease, is safe for patients with heart devices.
Many patients with sleep apnea also suffer from GI tract conditions
Patients who suffer from obstructive sleep apnea (OSA) also tend to have additional gastrointestinal (GI) tract conditions, such as gastric reflux and hiatal hernia, which form at the opening in your diaphragm where your food pipe (esophagus) joins your stomach.
ERCP quality outcomes in a community hospital setting compare favorably with academic centers
A new study from researchers in Minnesota found that endoscopic retrograde cholangiopancreatography (ERCP) performed in a community hospital setting results in complication rates that compare favorably with those of academic centers while achieving technical success at or above the performance levels recommended by the American Society for Gastrointestinal Endoscopy (ASGE)/American College of Gastroenterology (ACG) Task Force.
What are the risk factors for rebleeding after negative angiography?
Acute non-variceal gastrointestinal bleeding accounts for approximately 20% of emergency room visits and 5% of admissions.
Surgical treatment a rare complication of duodenal diverticulum
Most of the duodenal diverticula are diagnosed incidentally and asymptomatic, 12% to 27 % at endoscopy. Only 5% to 10% of patients with duodenal diverticula suffer from clinical symptoms.
Endoscopy within 24 hours shows better outcomes in elderly with peptic ulcer bleeding
A new study shows that elderly patients who underwent endoscopy within one day of presentation for peptic ulcer bleeding had a two-day shorter hospital stay and were less likely to require upper gastrointestinal surgery than patients who did not receive endoscopy within the first day of presentation.
Is it possible to differentiate GISTs from leiomyomas by endoscopic ultrasonography?
A research article to be published on July 21, 2009 in the World Journal of Gastroenterology addresses this question. This research led by Professor Kim and his colleagues in Pusan National University, South Korea.
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