Current Issue - Silder
Current Issue: June 2022
This month's highlight articles
Extending treatment criteria for Barrett’s neoplasia: results of a nationwide cohort of 138 endoscopic submucosal dissection procedures
The outcomes of 130 complete endoscopic submucosal dissections in patients with Barrettʼs esophagus-related neoplasia are reported. The R0 rate for high grade dysplasia/ T1a esophageal adenocarcinoma (EAC) was 87% and for T1b EAC it was 49 %. As only 29% of patients with an R1 resection had residual EAC at first endoscopic follow-up after 3 months, careful endoscopic examination at 3 months may help in selecting the optimal treatment approach.
The endoscopic ultrasound features of pancreatic fluid collections and their impact on therapeutic decisions: an interobserver agreement study
Among 12 EUS experts who evaluated 50 video clips of PFCs, there was poor-to-moderate agreement for the determination of PFC type and morphological features such as the percentage solid component and signs of infection. On therapeutic decisions, such as type of stent to use and the need for and timing of direct necrosectomy, there was moderate-to-substantial agreement. These findings indicate the need for standardization of the morphological criteria for EUS assessment of PFCs.
Endoscopic submucosal dissection for superficial gastrointestinal lesions: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2022
Superficial gastrointestinal lesions are being detected and diagnosed more commonly, and endoscopic resection is a mainstay treatment for them. In this updated ESGE Guideline on ESD for such lesions, recommendations are made for evaluation, treatment, and post-resection management, with special emphasis on the ESD technique. The Guideline addresses major issues, including evaluation before ESD, comparison with other therapeutic strategies (namely endoscopic mucosal resection [EMR] and surgery), and management after ESD, to inform and underpin the use of this fundamental technique for the treatment of superficial GI lesions.