Advances in Digestive Endoscopy

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Biomedical Optics".

Deadline for manuscript submissions: closed (30 September 2023) | Viewed by 3223

Special Issue Editor


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Guest Editor
Assistant Professor of Medicine, Department of Advanced Endoscopy and Gastroenterology, University of Texas Health, San Antonio, TX 78229, USA
Interests: advanced endoscopy; diagnosis of GI oncology; ERCP, EUS for treatment of pancreatico-biliary disorders; complex GI stricture treatment; third space endoscopy

Special Issue Information

Dear Colleagues,

Advanced endoscopy is a fascinating field and is evolving rapidly. It is proving to be an alternative procedure to surgery for treatment of complex medical problems. It is intensely satisfying to witness patients benefiting enormously from minimally invasive endoscopy. By avoiding surgery through a combination of advanced imaging technology used in minimally invasive endoscopy and the technical expertise of the clinician, potential surgical complications are minimized. Further, it enables faster recovery rates. This not only leads to higher patient satisfaction but is also of great importance in today’s context of rising healthcare costs.

The special issue on Advances in Digestive endoscopy will cover all aspects of advanced endoscopy such as treatment of Achalasia, Gastroparesis, Zenker’s diverticulam treatment, Bariatric endoscopy, endo-hepatology, Anti-reflux endoscopy, Diagnostic and therapeutic EUS, therapeutic endoscopy to achieve cure in cancer, GI tract mucosal resections including endoscopic mucosal and submucosal dissection, Robotics use in mucosal resection, use of artificial intelligence in endoscopy, treatment of Barrett’s esophagus, enteral stents, complex stricture remediation, use of newer tools in endoscopy and virtual chromoendoscopy.

Dr. Shreyas Saligram
Guest Editor

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Keywords

  • advanced endoscopy
  • EUS
  • ERCP
  • third space endoscopy
  • bariatric endoscopy
  • ESD
  • enteral stents

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Published Papers (1 paper)

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Research

10 pages, 409 KiB  
Article
Strategic Management of Bleeding Small Bowel Gastrointestinal Angiodysplasias (GIADs): A 12 Year Retrospective Review in a Veteran Population and Cost Comparison
by Mario Gutierrez, Chandrasekhar Kesavan, Anjali Das, Christian S. Jackson and Richard M. Strong
Diagnostics 2023, 13(3), 525; https://doi.org/10.3390/diagnostics13030525 - 31 Jan 2023
Cited by 6 | Viewed by 2599
Abstract
Background: Gastrointestinal angiodysplasias (GIADs), also known as gastrointestinal angioectasias, are dilated, abnormally thin-walled blood vessels that occur in the mucosa and submucosa throughout the gastrointestinal tract. As a common cause of small bowel bleeding, GIADs have a significant impact on patient’s morbidity and [...] Read more.
Background: Gastrointestinal angiodysplasias (GIADs), also known as gastrointestinal angioectasias, are dilated, abnormally thin-walled blood vessels that occur in the mucosa and submucosa throughout the gastrointestinal tract. As a common cause of small bowel bleeding, GIADs have a significant impact on patient’s morbidity and healthcare costs. Presently, somatostatin has been used widely to treat GIADs, but it is unclear if other therapies are as beneficial and cost-effective as somatostatin in managing GIADs. (2) Methods: A retrospective chart review was performed, which included subjects treated with Lanreotide, a somatostatin analog, and other therapies at the VA Loma Linda Healthcare System (VALLHCC) from January 2006 to December 2018. Patients who had symptomatic GIADs were detected by video capsule endoscopy (VCE), a device-assisted enteroscopy (DAE) or, in our case, push enteroscopy (PE) with an Endocuff. (3) Results: Three hundred twelve patients were diagnosed with GIADs. In this group of patients, 72 underwent ablation (endoscopic BICAP) with the addition of Lanreotide (SST), 63 underwent ablation therapy, eight were treated with SST only, 128 received iron replacement only, 25 received iron plus SST therapy, and 61 were observed with no therapy. Each group was followed via their hemoglobin (Hgb) level immediately thereafter, and Hgb levels were then obtained every 3 months for a 12-month period. After ablation therapy, 63 patients maintained stable Hgb levels over the course of the study, suggesting a significant therapeutic effect by controlling active bleeding. The 27 patients receiving ablation +SST therapy did not show improvements when compared to ablation only and the 128 patients who received iron therapy alone. (4) Conclusions: Importantly, 12 years of managing these patients has given us a cost- and time-sensitive strategy to maintain the patients’ Hgb levels and avoid hospital admissions for acute bleeding. Iron treatment alone is effective compared to SST treatment in recovering from GIADs. Eliminating SST treatment from therapeutic intervention would save $89,100–445,550 per patient, depending on the number of doses for private care patients and $14,286–28,772 for VA patients, respectively. A suggested therapy would be to perform DAE on actively bleeding patients, ablate the lesions using a coagulation method, and place the patient on iron. If that fails, gastroenterologists should repeat VCE and perform either PE with Endocuff or balloon enteroscopy (all DAEs). Full article
(This article belongs to the Special Issue Advances in Digestive Endoscopy)
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