[Endoscopic surgery in neoplasms of the upper digestive tract]

Endoscopic surgery has been performed since 1987 when in France the first laparoscopic cholecystectomy was done. Since then it has evolved and found a place in surgical practice. In the field of surgical oncology it has allowed the diagnosis, staging, resection and palliation of a great variety of neoplasms.

evaluate usefulness and recent advances of endoscopic surgery in neoplasms of the upper digestive tract, applied specifically to the esophagus and stomach.

We did a review of the medical literature using Medline data base (Pubmed). All series of cases, cohort and controlled studies published between January 1995 and April 2003 were included.

For esophageal carcinoma as well as for gastric carcinoma, endoscopic surgery is used as a complement for computed tomography and endoscopic ultrasound to define clinical stage, increasing sensibility to detect metastatic disease. Techniques of endoscopic or video assisted esophageal transhiatal and thoracoscopic resection have been described, as well as Japanese studies including radical gastric resections in early gastric cancer with multiple advantages. There are also several developing possibilities of palliative endoscopic or video assisted treatment which are discussed in this article.

Usefulness of endoscopic surgery in staging gastric and esophageal carcinoma is proven. Nevertheless oncologic endoscopic resections are still experimental and the advantages between these and open surgery are still to be shown with prospective randomized trials.