Endoscopic Palliation of Gastrointestinal Disease

Abstract

Gastrointestinal malignancies account for over 35% of cancer-related deaths with a projected 73% increase by 2040. Recent advances in endoscopic technique and devices have created exponential growth in the field of therapeutic gastroenterology and have enhanced diagnostic and treatment potential. As a result, palliative endoscopic therapies have experienced an equally tremendous amount of gain. Palliative endoscopy refers to maneuvers performed during gastrointestinal procedures with the intent to minimize patient suffering and discomfort. These procedures can be highly effective in providing rapid, non-operative relief and, as such, occupy an important role in the ability to alleviate symptoms of advanced malignancies throughout the gastrointestinal tract. Complications of end-stage malignances can result in tremendous discomfort, emotional trauma, and social embarrassment for the patient. Throughout the length of the gastrointestinal tract, there are a wide variety of endoscopic procedures that can provide relief in a minimally invasive fashion. The aim of this chapter is to provide insight into the current landscape of endoscopic procedures with the intent to minimize suffering, and provide a review of the indications, practice, and outcomes of endoscopic palliative therapies available.