Authors :
Abul Hasan Shadali Abdul Khader; Rakshaya Venu; Sruthi Nandhaa Shanmugam; Diviya Bharathi Ravikumar; Husna Qadeer; Shrinidhi Senthil Kumar; Barath Prashanth Sivasubramanian
Volume/Issue :
Volume 8 - 2023, Issue 9 - September
Google Scholar :
https://bit.ly/3TmGbDi
Scribd :
https://tinyurl.com/4dp5sh7d
DOI :
https://doi.org/10.5281/zenodo.8405099
Abstract :
This paper focuses on endoscopic therapeutic
advances in gastrointestinal conditions. Over-The-Scope
Clips (OTSC) are effective in non-variceal upper
gastrointestinal bleeds (NVUGIB) and have promising
results in large fibrotic ulcers. The Apollo endoscopic
suturing system is effective for refractory peptic
hemorrhage. Endoclip application +/- epinephrine is
considered for large peptic ulcers. Persistent bleeding is
controlled by Hemospray with a hemostatic endoscopic
procedure. Stand-alone therapies like Endoclot and
Polysaccharide hemostatic powder hold potential but
require further research. Endoscopic ultrasound-guided
cyanoacrylate and coil embolization are effective for
gastric varices, while Endoscopic Band Ligation is
preferred for esophageal varices. Endoscopic submucosal
dissection can excise Barrett's lesions of any size but is
challenging; hence, for multiband mucosectomy, an
Endoscopic mucosal resection (EMR) is used. Argon
plasma coagulation is effective for smaller lesions after
EMR. Radiofrequency ablation (RFA) is preferred for
Barrett's esophagus, and cryotherapy is used if RFA fails.
When life expectancy is less than two months, Self-
expanding metallic stent is preferred, and Endoscopic
gastrojejunostomy is provided when it is more than three
months. However, Brachytherapy is recommended for
long-term relief. Laser modalities show promise for mid-
esophageal tumors, while cryoablation compliments
others for advanced conditions. In conclusion, many
methods have a user-friendly interface and are easy to
master. The problems with resource availability, funding,
proper training, and the lack of larger studies still limit
some of the above-described techniques.
Keywords :
Endoscopy; Variceal ligation; Stenting; Cryoablation; Barrett’s.
This paper focuses on endoscopic therapeutic
advances in gastrointestinal conditions. Over-The-Scope
Clips (OTSC) are effective in non-variceal upper
gastrointestinal bleeds (NVUGIB) and have promising
results in large fibrotic ulcers. The Apollo endoscopic
suturing system is effective for refractory peptic
hemorrhage. Endoclip application +/- epinephrine is
considered for large peptic ulcers. Persistent bleeding is
controlled by Hemospray with a hemostatic endoscopic
procedure. Stand-alone therapies like Endoclot and
Polysaccharide hemostatic powder hold potential but
require further research. Endoscopic ultrasound-guided
cyanoacrylate and coil embolization are effective for
gastric varices, while Endoscopic Band Ligation is
preferred for esophageal varices. Endoscopic submucosal
dissection can excise Barrett's lesions of any size but is
challenging; hence, for multiband mucosectomy, an
Endoscopic mucosal resection (EMR) is used. Argon
plasma coagulation is effective for smaller lesions after
EMR. Radiofrequency ablation (RFA) is preferred for
Barrett's esophagus, and cryotherapy is used if RFA fails.
When life expectancy is less than two months, Self-
expanding metallic stent is preferred, and Endoscopic
gastrojejunostomy is provided when it is more than three
months. However, Brachytherapy is recommended for
long-term relief. Laser modalities show promise for mid-
esophageal tumors, while cryoablation compliments
others for advanced conditions. In conclusion, many
methods have a user-friendly interface and are easy to
master. The problems with resource availability, funding,
proper training, and the lack of larger studies still limit
some of the above-described techniques.
Keywords :
Endoscopy; Variceal ligation; Stenting; Cryoablation; Barrett’s.
