August 23, 2016

Advanced endoscopy and endotherapy

The endoscopy unit covers all the areas of advanced diagnosis and therapy performed through natural orifices. Early tumour detection and characterisation by endoscopy is more and more obtained by advanced imaging and many of these tumours become accessible to an endoluminal therapy avoiding the need of open or laparoscopic surgery. The areas of expertise at CF cover all the types of resection of superficial tumour in the GI tract (epidermoid cancer of the oesophagus, cancer developed on Barrett’s oesophagus, early cancer in the stomach, resection of superficial duodenal tumour or ampulloma and all the aspects of resection of superficial lesions into the rectum or the colon). The techniques used include endoscopic mucosal resection, endoscopic submucosal dissection and thermal ablation. Endotherapy may also cover all the aspects of palliation for tumour of the GI tract or biliopancreatic cancer. Novel techniques also allow to remove endoscopically submucosal tumour using only this access or in combination with laparoscopic surgery.

The development of these advanced techniques is also useful for management of complications of surgery such as anastomotic stricture, fistulas, leaks and collections. Echoendoscopic techniques allow to access almost all the collections located in the surrounding of the upper GI tract for treatment, sampling and/or characterisation. Endotherapy can also be offered to other groups of patients with non cancer related diseases and our group has acquired a large experience in management of Zenker diverticula, other diverticula of the GI tract, achalasia or diffuse oesophageal spasms by peroral endoscopic myotomy. Complications after oesophageal, biliopancreatic or bariatric surgery are also amenable to endoscopic therapy. Our equipment includes the latest technologies in flexible endoscopy, ERCP, echoendoscopy and fluoroscopy guided therapy.