Surgery of the upper departments of the digestive tract with intraoperative intra-research endoscopic assistance: review of the literature

Abstract

This analysis is based on the study of materials from scientific electronic libraries (elibrary.ru, PubMed, scientific library of the Petrovsky National Research Centre of Surgery, Moscow, Russia). The problem of treating the pathology of the upper gastrointestinal tract is caused by the high prevalence of benign and malignant diseases of this zone, their severity, the complexity of diagnosis and often the low efficiency of conservative therapy. Intensive implementation of innovative scientific technologies in medical practice, aimed at increasing the effectiveness of treatment and diagnostic measures, minimizing their negative impact on the patient’s body and reducing the risk of complications, which, at the same time, have sufficient economic attractiveness. In full, all of the above can be attributed to endoscopy, which has been actively developing in recent years, both in the diagnostic and in the operational areas. In the treatment of various diseases of the gastrointestinal tract in recent years, combined methods based on the use of two or more minimally invasive technologies, for example, endoluminal endoscopic and thoraco or laparoscopic methods, have entered the world practice. The data of scientific articles on the problem of surgical treatment of patients with benign and malignant diseases of the upper gastrointestinal tract, carried out using intraoperative intraluminal endoscopic assistant, are analyzed. The use of intraluminal endoscopy, in particular, allows to increase the radicality of surgical interventions in patients with malignant neoplasms of the upper gastrointestinal tract, perform intraoperative topical diagnosis of non-palpable tumors, and use it in the surgical treatment of esophageal diverticulums of various localization. Also, another area of application of intraoperative intraluminal endoscopy is the assessment of tightness and anastomosis zone during surgical interventions on the organs of the gastrointestinal tract. However, this technique is in the process of implementation in clinical practice and has not been sufficiently studied both in foreign and domestic literature.

Intraoperative intraluminal endoscopic assistance

“…Однако в литературе применение интраоперационной внутрипросветной эндоскопии освещено лишь со стороны традиционной хирургии. Имеются публикации об использовании внутрипросветной эндоскопии при дивертикулэктомии, фундопликации, оценки анастомоза желудочно-кишечного тракта [1][2][3][4][5][6][7][8]. Данная методика позволяет интраоперационно выявить такие осложнения анастомоза, как негерметичность, стеноз и кровотечение, а также скорректировать их в ходе операции, не допустив развития клинических проявлений в раннем послеоперационном периоде.…”