Update on endoscopic ultrasound: How much for imaging, needling, or therapy?

Papanikolaou, Ioannis S.; Fockens, Paul; Hawes, Robert H.; Rösch, Thomas

doi:10.1080/00365520701737252

Cited by 12 publications

(6 citation statements)

References 85 publications

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“…For example, EUS could replace MRI when local availability dictates it, e.g., when assessment for potential vascular invasion of a pancreatic head mass comes into question. In case the lesion is deemed operable, EUS-FNA should not be performed, as advocated by the current literature, and the EUS should serve only for diagnosis and/or staging [ 1 , 2 ].…”

Section: Qis In the Pre-procedures Phasementioning

confidence: 99%

“…The introduction of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), revolutionized the examination’s nature, adding an interventional aspect to its diagnostic core, allowing acquisition of tissue samples even from lesions outside the GI tract (e.g., in the pancreas). This particular feature differentiates EUS from other diagnostic modalities, including computed tomography or magnetic resonance imaging (MRI) [ 1 ]. On the other hand, quality indicators have been integrated into everyday GI endoscopy (GIE) practice, aiming to improve endoscopic services, each time taking into account the specific aspects of each patient’s disease and pursuing the ultimate goal: to provide optimal medical care [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Quality in pancreatic endoscopic ultrasound: what’s new in 2020?

Papanikolaou

Tziatzios

Gkolfakis

et al. 2020

aog

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Quality assessment and improvement of an endoscopic service has emerged as a basic component of everyday gastrointestinal endoscopy. In order to ensure a high level of quality, a series of actions must be adopted when performing an endoscopic examination. Nonetheless, quality still remains a qualitative parameter; thus, implementation of specific indicators of quality is warranted. Irrespective of the nature of the endoscopic procedure, quality indicators usually refer to either structural properties of an endoscopy unit (e.g., examination availability), procedural factors (e.g., diagnostic accuracy), or patient outcomes (e.g., occurrence of an adverse event related to performance of an endoscopic procedure). Moreover, they are usually classified into 3 distinct sections, according to the phase of the procedure they relate to: i.e., before, during, and after the examination. The aim of this review is to present measures that need to be adopted in order to reach an optimal quality level during an endoscopic ultrasound examination and to provide up-to-date data regarding the respective quality indicators implicated.

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Section: Qis In the Pre-procedures Phasementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Quality in pancreatic endoscopic ultrasound: what’s new in 2020?

Papanikolaou

Tziatzios

Gkolfakis

et al. 2020

aog

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“…EUS ! Der EUS hat sich als Methode zum Staging und zur Diagnose gastrointestinaler und pankreatobiliärer Erkrankungen [208,209] etabliert. Die Entwicklung der EUS-gestützten Feinnadelaspiration (EUS-FNA) schuf neue Möglichkeiten zur transmuralen Gewebediagnostik innerhalb [210][211][212][213] oder außerhalb [214][215][216] des Gastrointestinums und zur Entwicklung neuer Behandlungsindikationen durch EUS [217][218][219].…”

Section: Koloskopie Themenunclassified

GASTRO 2009 Bericht: Perspektiven der Endoskopie

Papanikolaou¹,

Rösch²

2010

Endo heute

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Digestive Endoscopy und der British Society of Gastroenterology als ein gemeinsames Meeting mit dem Weltkongress für Gastroenterologie unter dem Namen GASTRO 2009 organisiert worden. Es wurden viele Abstracts präsentiert. Sie konzentrierten sich auf Innovationen und neue Techniken oder betonten Themen mit einem Bezug zur klinischen Praxis. Dieser Bericht konzentriert sich auf Vorträge und einige wenige Poster, die aktuelle Fortschritte und die Forschung in der gastrointestinalen Endoskopie widerspiegeln. In einer kurzen Übersicht unter Berücksichtigung der aktuellen Literatur. Endoskopische Resektion und andere endoskopische Techniken: Von der therapeutischen Endoskopie zur endoskopischen "Chirurgie"? ! Die endoskopische Resektion prämaligner Läsionen und gastrointestinaler Frühkarzinome ist etabliert. Das Interesse wendet sich von den traditionellen Piecemeal-Techniken der endoskopischen Mukosaresektion (EMR) zur En-Block-Geweberesektion durch endoskopische Submukosadissektion (ESD) hin. Die EMR bleibt aber eine gute Alternative für Läsionen < 20 mm oder in westlichen Zentren, wo die Erfahrung mit der ESD nicht so fortgeschritten ist, wie in Japan [1-5]. Die große Akzeptanz der endoskopischen Resektion [6-15] hat zur Akkumulation von Erfahrung, neuen Indikationen und zur Entwicklung neuer Instrumente geführt. Dies zeigte sich in vielen Abstracts aus Europa, wie aus nichteuropäischen Zentren. Die Wiesbadener Gruppe präsentierte ihre gesamte Erfahrung aus einer großen Gruppe von 1 059 Patienten mit Barrett-Ösophagus (106 mit hochgradigen Dysplasien, 819 mit mukosalem Adenokarzinom und 134 mit submukosalem Adenokarzinom). Die Patienten erhielten eine endoskopische Resektion (2 142 Eingriffe) oder eine photodynamische Therapie (140 Eingriffe) mit einer mittleren Nachbeobachtungszeit von 56 Monaten. Eine komplette Remission wurde in 87 % aller Fälle und in 93,5 % der Mukosakarzinome erzielt, mit großem Nutzen und großer Sicherheit der endoskopischen Resektion bei diesen Patienten [16]. Die große Erfahrung mit der endoskopischen Resektion ermöglicht Vergleichstudien zwischen ESD und EMR. Eine retrospektive Studien an 122 Patienten (162 oberflächliche Ösophagustumoren) verglich die Effektivität [17]. Die makroskopischen und histologischen Resektionsraten der ESD-Gruppe waren signifikant besser für Tumoren > 20 mm, aber nicht signifikant für Tumoren < 20 mm (p < 0,001 und p = 0,09). Die Komplikationsraten unterschieden sich nicht. Lokalrezidive traten bei der EMR in 7,9 % bei der ESD 0 % auf. Erwartungsgemäß war die durchschnittliche Behandlungszeit für die ESD signifikant länger unabhängig von der Tumorgröße. Die Überlegenheit der ESD im Vergleich zur EMR durch Minimierung von Lokalrezidiven bei Ösophagustumoren > 20 mm wurde in einer großen japanischen Serie bestätigt [18]. Die Autoren schlossen an frühere Arbeiten [19] an und präsentierten eine Serie von 106 Läsionen, die mit einer endoskopischen Resektion behandelt worden waren. Es gab 11 / 57 Lokalrezidive in der EMR-Gruppe versus 1 / 49 in der ESD-Gruppe. Ob die R...

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“…EUS has established its role in the staging and diagnosis of gastrointestinal and pancreatobiliary pathologies [208,209]. Development of EUS-guided fine-needle aspiration (EUS-FNA) created new possibilities for transmural tissue diagnosis inside [210 -213] or outside [214 -216] of the gastrointestinal system, and allowed the development of new therapeutic indications for EUS [217 -219].…”

Section: Eus !mentioning

confidence: 99%

GASTRO 2009 report: putting endoscopy into perspective

Rösch²

2010

Endoscopy

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Various abstracts on endoscopic subjects were presented, many of which concentrated on innovations and new techniques, whereas others highlighted topics with an impact on clinical practice. This report focuses on oral presentations, as well as a few presented posters, which demonstrate latest advancements and research in gastrointestinal endoscopy and attempts to briefly review them in the light of recent literature.Endoscopic resection and other endotherapy techniques: from therapeutic endoscopy to endoscopic "surgery"? ! Endoscopic resection of premalignant lesions and early gastrointestinal cancers seems to be gradually coming of age, with a trend of shifting interest from the traditional piecemeal technique of endoscopic mucosal resection (EMR) to en bloc tissue resection by endoscopic submucosal dissection (ESD), although EMR remains a reasonable alternative for lesions < 20 mm or in Western centers, where experience in ESD is not as advanced as it is in Japan [1 -5]. Wide acceptance of endoscopic resection [6 -15] has lead to accumulation of experience, novel indications, and development of new instruments; this was reflected by various abstracts from Europe as well as from centers outside of Europe. The Wiesbaden group presented accumulated experience from their large cohort of 1059 patients with Barrett's esophagus (106 with high grade dysplasia, 819 with mucosal adenocarcinoma, and 134 with submucosal adenocarcinoma). Patients underwent endoscopic resection (2142 procedures) or photodynamic therapy (140 procedures) with a median follow-up of 56 months. Complete remission was achieved in 87 % of overall cases and 93.5 % of mucosal carcinomas, signifying efficacy and safety of endoscopic resection for these patients [16]. Accumulated experience with endoscopic resection led to the design of comparative studies between ESD and EMR; a retrospective study with 122 patients (162 superficial esophageal tumors), compared their efficacy [17]. Macroscopic and histological resection rates were better in the ESD group, significantly so for tumors > 20 mm, but nonsignificantly for tumors < 20 mm (P < 0.001 and P = 0.09, respectively); complication rates did not differ and local recurrence was 7.9 % for EMR and 0 % for ESD. As expected, average operation time was significantly longer for ESD, irrespective of tumor size. Superiority of ESD compared with EMR in minimizing local recurrence of esophageal tumors > 20 mm was highlighted in a large series from Japan [18]. Here the authors continued previous work [19] and presented a series of 106 lesions treated with endoscopic resection. There were 11/57 local recurrences in the EMR group versus 1/49 in the ESD group. Comparison of outcomes of esophageal endoscopic resection depending on histology (adenocarcinoma vs. squamous cell carcinoma) was examined in two studies. The first study, a European retrospective series, compared long-term safety and efficacy of endoscopic resection in 85 patients with mucosal squamous cell carcinoma with 98 Barrett carcinomas. Initial and lo...

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Update on endoscopic ultrasound: How much for imaging, needling, or therapy?

Cited by 12 publications

References 85 publications

Quality in pancreatic endoscopic ultrasound: what’s new in 2020?

Quality in pancreatic endoscopic ultrasound: what’s new in 2020?

GASTRO 2009 Bericht: Perspektiven der Endoskopie

GASTRO 2009 report: putting endoscopy into perspective

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