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Esophageal and Upper Interventional Endoscopy and Surgery: Latest Advances and...
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Esophageal and Upper Interventional Endoscopy and Surgery: Latest Advances and Prospects

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 (20 March 2026) | Viewed by 4307

Editor

Dr. Giulia Gibiino

E-Mail Website
Guest Editor
Gastroenterology and Digestive Endoscopy Unit, Forli-Cesena Hospitals, AUSL Romagna, 47121 Forlì, Italy
Interests: gastroenterology and digestive endoscopy; endoluminal endoscopy; chromoendoscopy; artificial intelligence; endoscopic submucosal dissection; endoscopic full-thickness resection

Special Issue Information

Dear Colleagues,

The approach to esophageal and gastric disease is evolving due to interventional endoscopy and mini-invasive surgery in the treatment of neoplastic and functional disorders. Devices, techniques, and sustainability in this setting are continuous issues that are constantly discussed and mentioned by the most recent guidelines and ongoing trials. After more than 20 years since the introduction of endoscopic submucosal dissection (ESD) for the treatment of early gastric cancer, upper endoscopy has been revolutionized by several different approaches; furthermore, oncologic disease is part of the endoscopic approach, even in cases of late stages due to frailty or old age. Curative endoscopic resections, palliative approaches by luminal stenting, and radiofrequency ablation are only some of the current advances. At the same time, the surgical approach remains a cornerstone of treatment for some conditions; in addition, some complications are managed in a complementary manner by endoscopists and surgeons.

In this Special Issue, we welcome authors to submit papers on original contributions, clinical studies, and reviews about esophageal, gastric, and upper endoscopy as well as surgery.

Dr. Giulia Gibiino
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gastric preneoplastic and neoplastic lesions
  • endoscopic submucosal dissection (ESD)
  • endoscopic full-thickness resection (EFTR)
  • subepithelial upper GI lesions
  • duodenal adenomas
  • esophageal stenting

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

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11 pages, 765 KB  
Article
Lactate in Drainage Fluid to Predict Complications in Robotic Esophagectomies—A Pilot Study in a Matched Cohort
by Julius Pochhammer, Sarah Kiani, Henning Hobbensiefken, Hilke Hobbensiefken, Benedikt Reichert, Terbish Taivankhuu, Thomas Becker and Jan-Paul Gundlach
J. Clin. Med. 2025, 14(17), 6190; https://doi.org/10.3390/jcm14176190 - 2 Sep 2025
Viewed by 1075
Abstract
Background/Objectives: Despite advances in minimally invasive procedures, anastomotic leakages (ALs) after esophageal resections mark the most feared complication. Its early detection can lead to quick interventional treatment with improved survival. Nonetheless, early detection remains challenging, and scores are imprecise and complex. Methods [...] Read more.
Background/Objectives: Despite advances in minimally invasive procedures, anastomotic leakages (ALs) after esophageal resections mark the most feared complication. Its early detection can lead to quick interventional treatment with improved survival. Nonetheless, early detection remains challenging, and scores are imprecise and complex. Methods: In our study we analyzed mediastinal drainage fluid to find parameters suggesting AL even before it became clinically evident and correlated them to routine biomarkers. All patients with AL after robotically assisted esophageal resections were included and matched 1:1 with uneventful controls. Additionally, transhiatal distal esophageal resections operated during this period were included. Drainage fluid was collected on postoperative days (PODs) 1–4 with consecutive blood gas analysis. Test quality was determined by the area under the curve (AUC) of the receiver operating characteristic curve (ROC). Results: In total, 40 patients were included, with 17 developing AL. There were no significant differences in gender, age, BMI or oncological treatment. The 30-day morbidity rate was 65.0%. The study was restricted to events in the first 12 days. While lactate value in drainage fluid differed significantly from POD 3 onwards in the two groups, serum CRP remained without significant differences. We developed the LacCRP score (CRP/30 + lactate/2). The AUC on POD 3 was 0.96, with a sensitivity and specificity of 100% and 75%, respectively. An estimator of 1.08 was found in multivariate analysis: one-point increase in the LacCRP score increases AL probability by 8%. Conclusions: This study demonstrates that postoperative lactate determinations in drainage fluid can predict AL after esophageal resection, and its combination with serum CRP results in a reliable LacCRP score. Full article
(This article belongs to the Special Issue Esophageal and Upper Interventional Endoscopy and Surgery: Latest Advances and Prospects)
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Review

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15 pages, 665 KB  
Review
Duodenal Trauma: Mechanisms of Injury, Diagnosis, and Management
by Raffaele Bova, Giulia Griggio, Serena Scilletta, Federica Leone, Carlo Vallicelli, Vanni Agnoletti and Fausto Catena
J. Clin. Med. 2026, 15(2), 567; https://doi.org/10.3390/jcm15020567 - 10 Jan 2026
Cited by 2 | Viewed by 2822
Abstract
Background: Traumatic injuries of the duodenum are generally rare but when they occur, they can result in serious complications. Inaccurate injury classification, delayed diagnosis, or late treatment can significantly raise morbidity and mortality. A multidisciplinary approach is often necessary. Mechanisms of injury [...] Read more.
Background: Traumatic injuries of the duodenum are generally rare but when they occur, they can result in serious complications. Inaccurate injury classification, delayed diagnosis, or late treatment can significantly raise morbidity and mortality. A multidisciplinary approach is often necessary. Mechanisms of injury: Isolated duodenal injuries are relatively uncommon due to the duodenum’s proximity to pancreas and major vascular structures. Duodenal injuries can result from blunt or penetrating trauma. Classification: The 2019 World Society of Emergency Surgery (WSES)-American Association for the Surgery of Trauma (AAST) guidelines recommend incorporating both the AAST-OIS grading and the patient’s hemodynamic status to stratify duodenal injuries into four categories: Minor injuries WSES class I, Moderate injuries WSES class II, Severe injuries WSES class III, and WSES class IV. Diagnosis: The diagnostic approach involves a combination of clinical assessment, laboratory investigations, radiological imaging and, in particular situations, surgery. Prompt diagnosis is critical because delays exceeding 24 h are associated with a higher incidence of postoperative complications and a significant rise in mortality. Contrast-enhanced abdominal computed tomography (CT) represents the gold standard for diagnosis in patients who are hemodynamically stable. Management: Duodenal trauma requires a multimodal approach that considers hemodynamic stability, the severity of the injury and the presence of associated lesions. Non-operative management (NOM) is reserved for hemodynamically stable patients with minor duodenal injuries without perforation (AAST I/WSES I), as well as all duodenal hematomas (WSES I–II/AAST I–II) in the absence of associated abdominal organ injuries requiring surgical intervention. All hemodynamically unstable patients, those with peritonitis, or with CT findings consistent with duodenal perforations or AAST grade III or higher injuries are candidates for emergency surgery. If intervention is required, primary repair should be the preferred option whenever feasible, while damage control surgery is the best choice in cases of hemodynamic instability, severe associated injuries, or complex duodenal lesions. Definitive reconstructive surgery should be postponed until the patient has been adequately resuscitated. The role of endoscopic techniques in the treatment of duodenal injuries and their complications is expanding. Conclusions: Duodenal trauma is burdened by potentially high mortality. Among the possible complications, duodenal fistula is the most common, followed by duodenal obstruction, bile duct fistula, abscess, and pancreatitis. The overall mortality rate for duodenal trauma persists to be significant with an average rate of 17%. Future prospective research needed to reduce the risk of complications following duodenal trauma. Full article
(This article belongs to the Special Issue Esophageal and Upper Interventional Endoscopy and Surgery: Latest Advances and Prospects)
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