Application of Endoscopy in the Diagnosis and Treatment of Digestive System Diseases

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Gastroenterology & Hepatology".

Deadline for manuscript submissions: closed (15 March 2026) | Viewed by 2135

Special Issue Editors


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Guest Editor
1. Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Faculty of Medicine, 377-2 Ohno Higashi, OsakaSayama 5898511, Osaka, Japan
2. Hellenic Red Cross Tracing Service, 21, 3rd Septemvriou, 10432 Athens, Greece
Interests: gastroenterology; hepatology; oncology; general and internal medicine; surgery

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Guest Editor Assistant
Endoscopy Center, Aishinkai Nakae Hospital, Wakayama-shi 640-8461, Wakayama, Japan
Interests: endoscopy; gastroenterology

Special Issue Information

Dear Colleagues,

Endoscopic examination has become an indispensable tool for diagnosing and treating gastrointestinal (GI) diseases. This minimally invasive procedure enables direct visualization of the GI tract, allowing for the accurate identification of pathological changes such as inflammation and tumors. Driven by technological innovations and new clinical insights, this field continues to evolve rapidly.

Recent years have witnessed remarkable advances in the treatment of upper GI tract diseases. The widespread eradication of Helicobacter pylori has significantly impacted the incidence of gastric tumors, prompting a re-evaluation of screening and surveillance strategies. Image-enhanced endoscopy (IEE) and artificial intelligence (AI) are revolutionizing diagnostic accuracy, while minimally invasive treatments such as endoscopic submucosal dissection (ESD), underwater endoscopic mucosal resection (U-EMR), and full-thickness resection are expanding therapeutic possibilities. Furthermore, in the endoscopic treatment of esophageal achalasia and gastroesophageal reflux disease (GERD), peroral endoscopic myotomy (POEM) and its derivative techniques are gaining attention as groundbreaking therapeutic methods.

In the lower GI tract, image-enhanced endoscopy and high-magnification observation, combined with AI-assisted diagnosis, are improving early detection and characterization of lesions. Therapeutic procedures—including cold forceps polypectomy (CFP), cold snare polypectomy (CSP), EMR, U-EMR, ESD, and hybrid ESD—have been refined through the development of new devices and techniques. However, challenges remain, such as determining appropriate treatment indications for colorectal serrated lesions and addressing small intestinal tumors in the context of advanced small-bowel endoscopy.

For inflammatory bowel diseases (ulcerative colitis and Crohn’s disease), technological innovations such as capsule endoscopy, balloon-assisted endoscopy, special light observation, and ESD are at the forefront of improving diagnosis and treatment.

In advanced malignancies, the roles of endoscopic biopsy, management of immune checkpoint inhibitor-related adverse events, and minimally invasive procedures are being actively explored.

Through this Special Issue, we aim to highlight the latest advances, share current challenges, and introduce new insights from the field of gastrointestinal endoscopy. We invite submissions that address technological innovations, clinical applications, and future directions in order to develop a more effective clinical system for patients and practitioners alike.

We look forward to receiving your valuable contributions and to advancing the field together.

Dr. Yoriaki Komeda
Guest Editor

Dr. Konosuke Nakaji
Guest Editor Assistant

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Keywords

  • image-enhanced endoscopy (IEE)
  • artificial intelligence (AI)
  • endoscopic submucosal dissection (ESD)
  • peroral endoscopic myotomy (POEM)
  • underwater endoscopic mucosal resection (U-EMR)
  • helicobacter pylori eradication
  • capsule endoscopy
  • balloon-assisted endoscopy
  • endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA)
  • interventional EUS
  • colorectal serrated lesions

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Published Papers (1 paper)

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Review

16 pages, 1236 KB  
Review
Pancreatic Metastases from Clear Cell Renal Cell Carcinoma: Diagnostic Insights from Endoscopic Ultrasound-Guided Fine-Needle Biopsy
by Alexandru Constantinescu, Ion Dina, Maria Nedelcu, Vlad Dumitru Băleanu, Vasile Florescu, Laura Enache, Octavian Andronic, Daniel Voiculescu and Ancuța Năstac
Medicina 2026, 62(2), 239; https://doi.org/10.3390/medicina62020239 - 23 Jan 2026
Viewed by 1527
Abstract
Clear cell renal cell carcinoma (ccRCC) is the most common type of kidney cancer, accounting for approximately 75–80% of all renal carcinomas, and is often diagnosed incidentally on abdominal imaging, such as abdominal ultrasound or CT scan. Among other types of renal cancer, [...] Read more.
Clear cell renal cell carcinoma (ccRCC) is the most common type of kidney cancer, accounting for approximately 75–80% of all renal carcinomas, and is often diagnosed incidentally on abdominal imaging, such as abdominal ultrasound or CT scan. Among other types of renal cancer, ccRCC is recognized to be highly aggressive due to its metastatic potential, which leads to a poor prognosis and an increased mortality rate. The most common sites of ccRCC metastasis are the lung, lymph nodes, bone, liver, and adrenal glands. Clear cell RCC is the most frequent primary tumor associated with secondary pancreatic involvement, while overall, pancreatic metastases represent only 2–5% of all malignant pancreatic lesions. These metastases often occur many years after nephrectomy and may present as solitary or oligometastatic disease, frequently displaying a paradoxically favorable prognosis compared with other metastatic sites. The present narrative review we conducted emerged from presentations of ccRCC with pancreatic distant metastases, potentially labeled as primary pancreatic tumors on imaging studies, mimicking pancreatic neuroendocrine tumors due to the hypervascular nature of ccRCC. Four patients were investigated in our clinic for suspicious pancreatic lesions identified on CT imaging, involving both the head and body of the pancreas. The definitive diagnosis was established by performing endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) or fine-needle biopsy (FNB) and histopathological analysis of the collected tissue samples. Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) has emerged as a pivotal tool for obtaining tissue diagnosis, particularly when cross-sectional imaging is inconclusive. Through a synthesis of clinical data and literature, this article underscores the essential diagnostic role of EUS-guided tissue acquisition and its impact on therapeutic decision-making. Full article
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