Endoscopic Submucosal Tunnel Dissection as a Novel Therapeutic Technique in Patients With Barrett’s Esophagus

Abstract

With the ameliorated resectability prowess of endoscopic techniques, a myriad of diseases previously treated by major ablative surgeries are now endoscopically curable. Endoscopic submucosal tunnel dissection (ESTD) is a relatively new technique that has diversified endoscopic application. Although ESTD has frequently been used for the resection of esophageal neoplastic lesions, the clinical evidence pertaining to its efficacy in the treatment of circumferential Barrett’s esophagus remains sparse. In this study, we evaluated ESTD as a potential therapeutic technique in patients with Barrett’s esophagus-related high-grade dysplasia. The tunneling strategy helped achieve complete en bloc resection at an increased dissection speed, without any procedural complications. This article illustrates that ESTD can be a feasible, safe, and effective treatment for dysplastic Barrett’s esophagus. Future research should aim to stratify the potential risks and complications associated with this optimization of endoscopic submucosal dissection in patients with superficial esophageal lesions.

Endoscopic Therapy in the Management of Patients With Severe Rectal Bleeding Following Transrectal Ultrasound-Guided Prostate Biopsy: A Case-Based Systematic Review

“…Combination endoscopic therapy, consisting of varying combinations of epinephrine injection, endoclipping, and/or endoscopic band ligation, has also been used with good clinical outcomes. 8 , 48 , 49 …”

“…Combination endoscopic therapy, consisting of varying combinations of epinephrine injection, endoclipping, and/or endoscopic band ligation, has also been used with good clinical outcomes. 8,48,49 The use of endoclipping has been widely reported in gastrointestinal endoscopy. However, the placement of endoclips alone for post-biopsy rectal bleeding has rarely been described thus far.…”

“…6 With the ameliorated therapeutic prowess of endoscopy, a plethora of gastrointestinal disorders previously managed with surgical intervention are now endoscopically amenable. [7][8][9] Therefore, endoscopic therapy can also be safely opted for severe gastrointestinal bleeding complications that once required surgery for hemostasis. In this context, endoscopic evaluation of patients presenting with massive post-biopsy rectal hemorrhage may allow immediate and effective therapy.…”