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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 RSSStudy identifies double-balloon enteroscopy as cost-effective approach for obscure GI bleeding
A cost-effectiveness analysis conducted by researchers at Stanford University Hospital in Calif., shows that an initial double-balloon enteroscopy (DBE) is a cost-effective approach for patients with obscure gastrointestinal (GI) bleeding.
New research finds markers for esophageal cancer before it develops
Rhode Island Hospital researchers have identified genetic proteins, also known as biomarkers, capable of distinguishing changes at the microscopic level that can signal a precancerous condition in the esophagus.
Study reports Double Balloon Endoscopy useful for diagnosis and treatment of obscure GI bleeding
A study by researchers in Japan concludes that Double Balloon Endoscopy (DBE) was very useful in the diagnosis of obscure gastrointestinal (GI) bleeding and had a therapeutic impact on the majority of patients.
What is the relationship between laryngopharyngeal reflux and reflux esophagitis?
The association between gastroesophageal reflux disease (GERD) and laryngeal disorders has been recognized since the late 1960s.
Mayo Clinic study tackles labeling errors
With a long-held commitment to continuously improving the quality and safety of patient care, Mayo Clinic researchers are recommending a new technologically-advanced labeling system aimed at reducing specimen labeling errors in a high-volume gastrointestinal endoscopy center
Endoscopic therapy may offer an alternative to surgery
Endoscopic therapy is emerging as an alternative to surgery in patients with esophageal cancer given the low likelihood of spread to the lymph nodes.
Endoscopy may not be necessary in asymptomatic children after caustic ingestion
A new study from researchers in Italy reports that endoscopy may not be necessary in children who show no symptoms after a caustic ingestion.
What is the clinical features of primary aortoenteric fistula?
PAEF is a rare but often life-threatening cause of massive gastrointestinal bleeding. PAEFs have a mortality rate of nearly 100% in the absence of surgical intervention, and in most case, the diagnosis is not established preoperatively.
Risk of colorectal cancer extremely low 5 years after a normal colonoscopy screening
A study appearing in the Sept. 18 issue of the New England Journal of Medicine shows that among individuals with no colorectal neoplasia (abnormal growths) on initial screening colonoscopy, the five-year risk of colorectal cancer is extremely low.
How to diagnoses and treat biliary rhabdomyosarcoma efficiently?
BRMS is an uncommon cause of recurrent jaundice and conjugated hyperbilirubinemia in children. Because its presentation may mimic that of a choledochal cyst, the correct diagnosis is frequently made intraoperatively at a planned choledochal cystectomy.
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