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Related Concept Videos

Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

Endoscopic Procedures I: Esophagogastroduodenoscopy

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An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
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Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
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Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

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Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
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Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
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Peptic Ulcer Disease V: Surgical Management and Nursing Care01:25

Peptic Ulcer Disease V: Surgical Management and Nursing Care

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Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
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Barrett Esophagus-II: Clinical Manifestations and Management01:21

Barrett Esophagus-II: Clinical Manifestations and Management

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Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
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Non-Curative Endoscopic Submucosal Dissection: Current Concepts, Pitfalls and Future Perspectives.

João Santos-Antunes1,2,3

  • 1Gastroenterology Department, Porto WGO Training Center, Centro Hospitalar S. João, 4200-319 Porto, Portugal.

Journal of Clinical Medicine
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Summary

Endoscopic submucosal dissection (ESD) effectively treats digestive tract neoplasia but can result in non-curative resections. Managing these cases requires careful consideration of patient factors and treatment options for optimal oncological outcomes.

Keywords:
digestive tract neoplasiaearly cancerendoscopic submucosal dissectionendoscopic treatmentnon-curative

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Endoscopic Procedures

Background:

  • Endoscopic submucosal dissection (ESD) is a primary treatment for digestive tract neoplasia.
  • ESD is technically demanding, leading to a significant rate of non-curative resections due to lesion characteristics and endoscopist experience.
  • The optimal management strategy for patients following non-curative ESD remains undefined.

Purpose of the Study:

  • To review the curativeness of ESD for esophageal, gastric, and colorectal lesions.
  • To discuss the management of patients who have undergone non-curative ESD.
  • To highlight the challenges in predicting residual disease and guiding complementary treatment decisions.

Main Methods:

  • Literature review of studies on ESD curativeness and post-procedural management.
  • Analysis of factors influencing ESD resection outcomes.
  • Evaluation of complementary treatment options (surgery, chemotherapy, radiotherapy) for non-curative cases.

Main Results:

  • Non-curative ESD rates vary based on lesion specifics and operator skill.
  • Predicting residual neoplasia after ESD is challenging, with many surgical resections revealing no residual disease.
  • Histological criteria for non-curative ESD have differing implications for residual risk.

Conclusions:

  • Careful patient selection and procedural technique are crucial for maximizing ESD curativeness.
  • Individualized management plans are necessary for non-curative ESD, balancing treatment benefits against patient comorbidities and survival.
  • Further research is needed to improve the prediction of residual disease and refine treatment algorithms for non-curative ESD cases.