Global Updates and Advances in GI Endoscopy in Luminal and Non-luminal GI Conditions

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: closed (25 August 2022) | Viewed by 6651

Special Issue Editors


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Guest Editor
Department of Gastroenterology and Hepatology, Kansas City VA Medical Center, 4801 Linwood Blvd, Kansas City, MO 64128, USA
Interests: cancer; gastroenterology; endoscopy; advance endoscopy

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Guest Editor
Div Intervent Oncol & Surg Endoscopy, Parkview Cancer Institute, Ft Wayne, IN 46845 USA
Interests: Cancer; Gastroenterology; Endoscopy; advance endoscopy

Special Issue Information

Dear Colleagues,

Gastrointestinal (GI) endoscopy entails the use of flexible fiberoptic endoscopes to diagnose and manage complex GI luminal and non-luminal diseases. Upper and lower endoscopy have been traditionally utilized for basic diagnostics centered around GI and colorectal conditions. However, with advances in the field, there has been remarkable progress in the use of endoscopic imaging in luminal (esophagus, gastric, small intestinal, and colorectum) and pancreaticobiliary disorders. The use of stents (enteral, lumen apposing, biliary and pancreatic), radiofrequency ablation techniques (for Barrett’s disease, tumors such as cholangiocarcinoma), enhanced visualization of the bile duct (via cholangioscopy) and pancreatic duct (via pancreatoscopy) created the ability to enter areas and manage diseases which were never thought to be possible via endoscopy. Furthermore, endoscopic ultrasound (EUS) has continued to open new doors for diagnostic and therapeutic endoscopy in the mediastinum, foregut, liver, pancreaticobiliary and areas adjacent to the duodenum and rectosigmoid colon. Evolving from imaging and aspirates only, EUS now offers core biopsy, fiducial marker placements, and a multitude of interventions. It has also become vital in cancer diagnosis and staging.

Given these updates, the development of a focused issue of advances in the use of GI endoscopy in the diagnosis, management, and treatment of GI disorders remains a priority. In this section of “updates and advances of GI endoscopy in luminal and non-luminal GI disorders”, we aim to specifically focus on developments in GI endoscopy in the last decade. Clinicians in a variety of fields can gain an understanding of the use of these endoscopic advances to facilitate referral options for minimally invasive endoscopy to diagnose and treat their patients across a spectrum of diseases.

We aim to both educate and assist in developing insights and strategies in this evolving field.

The topics outlined below will be the main focus of this issue:

  1. Barrett’s disease and role of GI endoscopy in diagnosis, treatment, and surveillance;
  2. Advances in GERD diagnosis, management, and treatment with endoscopy;
  3. EUS-guided pancreaticobiliary, hepatic imaging, and interventions;
  4. Types of gastric polyps, their malignant potential, resection, and surveillance;
  5. Role of EUS in precancerous and non-cancerous pancreatic cyst diagnosis and management;
  6. Types of colon polyps, their malignant potential, resection, and surveillance;
  7. Use of endoscopy (cholangioscopy and pancreatoscopy) to diagnose early-stage biliary and pancreatic tumors;
  8. Role of endoscopy, EUS, stenting in luminal GI cancer diagnosis and staging;
  9. The potential of GI endoscopy to cure early cancer: Comprehensive use of methods for resection of mucosal and submucosal lesions;
  10. The role of Gi endoscopy in the mediastinum;
  11. Novel frontiers for endoscopy outside the spectrum of traditional GI disease;
  12. The future of GI endoscopy in cancer centers: Time to rethink the role of endoscopists as forerunners of cancer care;
  13. Multidisciplinary care approaches and how to incorporate endoscopy into the paradigm of interdisciplinary care;
  14. Use of videos and telemedicine in gastrointestinal disorders: Endoscopist perspective.

Dr. Abhilash Perisetti
Dr. Neil R. Sharma
Guest Editors

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Keywords

  • endoscopy
  • gastrointestinal endoscopy
  • pancreaticobiliary disorders
  • cancer prevention
  • polyps

Published Papers (3 papers)

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Research

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10 pages, 3631 KiB  
Article
Efficacy of Combination Therapy with Epinephrine Local Injection and Hemostatic Clips on Active Diverticular Bleeding
by Seiji Hamada, Akira Teramoto, Ryuta Zukeyama, Shinobu Matsukawa, Tomofumi Fukuhara, Ryo Takaki, Takahiro Utsumi, Masamoto Nakamura, Kasen Kobashikawa, Nobufumi Uchima, Tomokuni Nakayoshi and Fukunori Kinjo
J. Clin. Med. 2022, 11(17), 5195; https://doi.org/10.3390/jcm11175195 - 2 Sep 2022
Cited by 2 | Viewed by 2149
Abstract
Epinephrine local injection is a hemostatic procedure used in active diverticular bleeding that elicits vasoconstriction and tamponade effects. We compared the additional benefit of combination therapy with HSE-C (hypertonic saline epinephrine injection with clipping) to clipping monotherapy. Retrospective data on diverticular bleeding between [...] Read more.
Epinephrine local injection is a hemostatic procedure used in active diverticular bleeding that elicits vasoconstriction and tamponade effects. We compared the additional benefit of combination therapy with HSE-C (hypertonic saline epinephrine injection with clipping) to clipping monotherapy. Retrospective data on diverticular bleeding between 2011 and 2016 was reviewed. Those with an active bleeding source confirmed by colonoscopy (excluding non-bleeding vessels and adherent clots) who received either HSE-C or clipping were evaluated. Endpoints were rates of successful primary hemostasis, recurrent bleeding, and surgical intervention during hospitalization. A total of 320 patients with diverticular bleeding were evaluated, on which either HSE-C (n = 35) or clipping monotherapy (n = 18) was performed. Rates of successful primary hemostasis (91.4% vs. 66.7%, p = 0.048) and direct placement of endoclips (60.0% vs. 16.7%, p = 0.004) were significantly higher in the HSE-C group. Although not statistically significant, the HSE-C group had a higher rate of early rebleeding (18.8% vs. 8.3%, p = 0.653), while no difference was seen in the number of patients requiring surgery (11.4% vs. 5.5%, p = 0.651). HSE-C is associated with a higher rate of successful primary hemostasis for severe active diverticular bleeding but has no significant difference in reducing early recurrent bleeding or the number of patients requiring surgery, suggesting that hemostatic effects may be temporary. Full article
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Review
A Comprehensive Guide to Artificial Intelligence in Endoscopic Ultrasound
by Kareem Khalaf, Maria Terrin, Manol Jovani, Tommy Rizkala, Marco Spadaccini, Katarzyna M. Pawlak, Matteo Colombo, Marta Andreozzi, Alessandro Fugazza, Antonio Facciorusso, Fabio Grizzi, Cesare Hassan, Alessandro Repici and Silvia Carrara
J. Clin. Med. 2023, 12(11), 3757; https://doi.org/10.3390/jcm12113757 - 30 May 2023
Cited by 7 | Viewed by 2329
Abstract
Background: Endoscopic Ultrasound (EUS) is widely used for the diagnosis of bilio-pancreatic and gastrointestinal (GI) tract diseases, for the evaluation of subepithelial lesions, and for sampling of lymph nodes and solid masses located next to the GI tract. The role of Artificial Intelligence [...] Read more.
Background: Endoscopic Ultrasound (EUS) is widely used for the diagnosis of bilio-pancreatic and gastrointestinal (GI) tract diseases, for the evaluation of subepithelial lesions, and for sampling of lymph nodes and solid masses located next to the GI tract. The role of Artificial Intelligence in healthcare in growing. This review aimed to provide an overview of the current state of AI in EUS from imaging to pathological diagnosis and training. Methods: AI algorithms can assist in lesion detection and characterization in EUS by analyzing EUS images and identifying suspicious areas that may require further clinical evaluation or biopsy sampling. Deep learning techniques, such as convolutional neural networks (CNNs), have shown great potential for tumor identification and subepithelial lesion (SEL) evaluation by extracting important features from EUS images and using them to classify or segment the images. Results: AI models with new features can increase the accuracy of diagnoses, provide faster diagnoses, identify subtle differences in disease presentation that may be missed by human eyes, and provide more information and insights into disease pathology. Conclusions: The integration of AI in EUS images and biopsies has the potential to improve the diagnostic accuracy, leading to better patient outcomes and to a reduction in repeated procedures in case of non-diagnostic biopsies. Full article
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18 pages, 306 KiB  
Review
Updates in Endoscopic Bariatric and Metabolic Therapies
by Hammad Qureshi, Naba Saeed and Manol Jovani
J. Clin. Med. 2023, 12(3), 1126; https://doi.org/10.3390/jcm12031126 - 31 Jan 2023
Cited by 5 | Viewed by 1549
Abstract
The rising prevalence of obesity, and related morbidity and mortality, has necessitated the development of therapeutic weight loss strategies. Lifestyle modifications alone have only yielded modest benefit, and while bariatric surgery has shown significant short- and long-term results, only a minority of eligible [...] Read more.
The rising prevalence of obesity, and related morbidity and mortality, has necessitated the development of therapeutic weight loss strategies. Lifestyle modifications alone have only yielded modest benefit, and while bariatric surgery has shown significant short- and long-term results, only a minority of eligible patients end up receiving this treatment. Endoscopic bariatric and metabolic therapies (EBMTs) are a rapidly evolving field, which provides a less invasive middle ground treatment option for weight loss. Here we discuss the efficacy, as well as short- and long-term outcomes with restrictive, malabsorptive/metabolic and aspiration endoscopic techniques, and their effects on metabolic parameters. Full article
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