Indications and benefits of intraoperative esophagogastroduodenoscopy.

Abstract

IntroductionIntraoperative esophagogastroduodenoscopy (IOG) is a diagnostic and therapeutic method for a variety of special conditions in upper gastrointestinal (UGI) pathology. The indication remains individual due to insufficient evidence and limited training of surgeons in digestive endoscopy.AimTo evaluate the indications, benefits and risks of IOG.Material and methodsA single-center retrospective study of 110 consecutive IOGs in 104 patients was performed. The preoperative plan, the timing of IOG, preoperative evaluation, intraoperative finding, localization of the pathology, type of the procedure, change of expected therapy and complications were assessed.ResultsThe cohort comprised 29 esophageal tumors, 5 tumors of the cardia, 36 gastric tumors, gastrointestinal bleeding (8), esophageal diverticula (3), perforations (3), GERD (5), mediastinal pathology (3), fistula (4), assessment of nutrition (10), duodenal adenoma (2), ulcer disease, esophageal stenosis and gastric volvulus. The indication for IOG was established preoperatively in 79% and intraoperatively in 21%. The lesion was localized in 96.4%. The therapy was altered to a wider resection (11), smaller resection (5), localization and surgical therapy of bleeding (8) or allowed minimally invasive surgery (25). A total of 3 postoperative complications included gastric perforation and positivity of resection line (following EMR/ESD) and recurrent bleeding. The 30-day mortality reached 3.6% without a specific cause in IOG.ConclusionsThe IOG is a complementary method in the diagnosis and treatment of UGI pathology. It enables minimally invasive finalization of the procedures and individualization of the therapy.

Use of the endoscopic vacuum therapy technique for the treatment of esophageal fistulas: an integrative review and clinical case series study

“…These studies reinforce that the use of VEC as a multidisciplinary endoscopic and surgical approach is a successful therapy for the management of suture dehiscence with esophageal anastomotic leaks after thoracic surgery or esophageal perforations [15]. thus being a safe and highly effective therapeutic option even for extensive anastomotic defects [16].…”

“…The patient was discharged to a rehabilitation unit on the 90th postoperative day. Follow-up 3 months after discharge confirmed the patient's satisfactory performance results with full recovery from the esophageal injury [16].Thus, Stašek et al[16] described that the use of VEC as a…”

The Efficacy of Intraoperative Esophagogastroduodenoscopy in Localizing Retroperitoneal Bowel Injury: A Case Report

“…In the specialized context of trauma-induced duodenal hematoma, an intraoperative EGD can be increasingly helpful for rapidly identifying retroperitoneal bowel injuries without the need for the Kocher maneuver [ 1 , 2 ]. Duodenal hematoma, a consequence of trauma, poses unique challenges owing to the intricate proximity of the duodenum to surrounding structures.…”

“…In situations where suspicion arises regarding retroperitoneal bowel injury in the context of duodenal hematoma, the incorporation of intraoperative EGD emerges as a pivotal and instrumental diagnostic and therapeutic tool [ 1 , 2 ]. This sophisticated instrument facilitates a meticulous examination of the bowel wall, a particularly critical aspect when the hematoma exerts compressive forces or induces distortions in the duodenum, thereby increasing its vulnerability to injury [ 3 ].…”

“…The immediate and detailed visualization provided by EGD becomes a guiding beacon for the surgical team, directing their attention to specific areas that necessitate intervention [ 5 ]. Integrating EGD into the surgical protocol not only aids in promptly identifying retroperitoneal injuries but also guides subsequent therapeutic interventions, ultimately enhancing patient outcomes in duodenal hematoma-induced trauma [ 1 , 2 ].…”