{"title":"Colon cancer: is the robot a better option?","authors":"Felipe F. Quezada-Diaz, J. Joshua Smith","doi":"10.21037/ales-23-16","DOIUrl":"https://doi.org/10.21037/ales-23-16","url":null,"abstract":"","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
: Endoscopic submucosal dissection (ESD), first developed in Japan, is increasingly performed worldwide to allow en bloc removal of large lesions from the gastrointestinal tract. Colorectal ESD results in higher en bloc and R0 resection rates than those in endoscopic mucosal resection (EMR), thus reducing the risk of local recurrence and allowing accurate pathological evaluations. Compared with surgical resection, ESD is better tolerated by patients, with reduced adverse event rates, hospitalization durations, and costs. Colorectal ESD is most appropriate for lesions larger than 20 mm with a risk of submucosal invasion and that are difficult to remove en bloc or for lesions in which previous EMR had failed or was not possible. However, inferior en bloc and R0 resection rates of colorectal ESD have been reported in the US compared to those in Japan, potentially due to increased technical challenges secondary to higher prevalence of obesity and significantly greater occurrence of fibrotic lesions in the US due to previous resection attempts. Recently, colorectal ESD guidelines have been updated, and various techniques and technologies have been developed to improve colorectal ESD outcomes, reduce procedure time, and overcome technical challenges. This article will discuss updated indications, new devices, resection strategies, technique variations, and clinical outcomes of colorectal ESD with regional comparisons (i.e., North America, Europe, and Japan).
{"title":"Endoscopic submucosal dissection of neoplastic lesions of the colon: clinical application and techniques","authors":"Thomas J. Wang, Hiroyuki Aihara","doi":"10.21037/ales-23-12","DOIUrl":"https://doi.org/10.21037/ales-23-12","url":null,"abstract":": Endoscopic submucosal dissection (ESD), first developed in Japan, is increasingly performed worldwide to allow en bloc removal of large lesions from the gastrointestinal tract. Colorectal ESD results in higher en bloc and R0 resection rates than those in endoscopic mucosal resection (EMR), thus reducing the risk of local recurrence and allowing accurate pathological evaluations. Compared with surgical resection, ESD is better tolerated by patients, with reduced adverse event rates, hospitalization durations, and costs. Colorectal ESD is most appropriate for lesions larger than 20 mm with a risk of submucosal invasion and that are difficult to remove en bloc or for lesions in which previous EMR had failed or was not possible. However, inferior en bloc and R0 resection rates of colorectal ESD have been reported in the US compared to those in Japan, potentially due to increased technical challenges secondary to higher prevalence of obesity and significantly greater occurrence of fibrotic lesions in the US due to previous resection attempts. Recently, colorectal ESD guidelines have been updated, and various techniques and technologies have been developed to improve colorectal ESD outcomes, reduce procedure time, and overcome technical challenges. This article will discuss updated indications, new devices, resection strategies, technique variations, and clinical outcomes of colorectal ESD with regional comparisons (i.e., North America, Europe, and Japan).","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Minimally invasive colorectal surgery—the sky is the limit","authors":"Alessandro Fichera","doi":"10.21037/ales-23-47","DOIUrl":"https://doi.org/10.21037/ales-23-47","url":null,"abstract":"","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer Koh, Miranda V. Shum, Joo Ha Hwang, Robert J. Huang
: Non-cardiac gastric adenocarcinoma (NCGA) remains a leading source of global morbidity and mortality. Despite its lower incidence in the United States and Western Europe, the overall poor survival and prognosis from this cancer suggest a need for earlier detection. NCGA develops through a well-known stepwise progression of precursor lesions, including chronic gastritis, atrophic gastritis, intestinal metaplasia, and dysplasia. Identification and surveillance of high-risk individuals carrying these precursors may be one important avenue to improve NCGA outcomes through earlier detection. In addition, identifying NCGA precursors creates an opportunity for definitive management with early endoscopic resection, and therefore a potential for reduction in cancer morbidity and mortality. This review has two main objectives. The first aim is to describe and evaluate various imaging technologies that are currently used to aid and improve the endoscopic detection of NCGA precursor lesions. These modalities include image-enhanced endoscopy (both dye-based and virtual), confocal laser endomicroscopy, and auto-fluorescence imaging. The second aim is to appraise current surveillance strategies for individuals carrying precursor lesions, with an emphasis on synthesizing recommendations from several recent surveillance guidelines published in the United States and Europe. In this review, we also highlight future innovative technologies and directions, including the utilization of artificial intelligence for rapid lesion recognition and molecular-based individual risk stratification.
{"title":"Detection and surveillance of gastric cancer precursors: evolving guidelines and technologies","authors":"Jennifer Koh, Miranda V. Shum, Joo Ha Hwang, Robert J. Huang","doi":"10.21037/ales-23-13","DOIUrl":"https://doi.org/10.21037/ales-23-13","url":null,"abstract":": Non-cardiac gastric adenocarcinoma (NCGA) remains a leading source of global morbidity and mortality. Despite its lower incidence in the United States and Western Europe, the overall poor survival and prognosis from this cancer suggest a need for earlier detection. NCGA develops through a well-known stepwise progression of precursor lesions, including chronic gastritis, atrophic gastritis, intestinal metaplasia, and dysplasia. Identification and surveillance of high-risk individuals carrying these precursors may be one important avenue to improve NCGA outcomes through earlier detection. In addition, identifying NCGA precursors creates an opportunity for definitive management with early endoscopic resection, and therefore a potential for reduction in cancer morbidity and mortality. This review has two main objectives. The first aim is to describe and evaluate various imaging technologies that are currently used to aid and improve the endoscopic detection of NCGA precursor lesions. These modalities include image-enhanced endoscopy (both dye-based and virtual), confocal laser endomicroscopy, and auto-fluorescence imaging. The second aim is to appraise current surveillance strategies for individuals carrying precursor lesions, with an emphasis on synthesizing recommendations from several recent surveillance guidelines published in the United States and Europe. In this review, we also highlight future innovative technologies and directions, including the utilization of artificial intelligence for rapid lesion recognition and molecular-based individual risk stratification.","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":"136 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael A. Huber, Justin M. Robbins, Stacy M. Sebastian, Alexander Hien Vu, George Ferzli, Richard Schutzer, Anil Hingorani
Background and Objective: The use of robot technology has greatly expanded the field of general surgery. While robot technology has become almost standard for many general surgeons, there is an increasing interest in how this same technology may be utilized within more specialized fields. We sought to explore the advances and current uses of robot technology within the field of vascular surgery. We evaluated this topic broadly in the context of both open and endovascular approaches.
{"title":"Robotic approaches for vascular and endovascular procedures: a narrative review","authors":"Michael A. Huber, Justin M. Robbins, Stacy M. Sebastian, Alexander Hien Vu, George Ferzli, Richard Schutzer, Anil Hingorani","doi":"10.21037/ales-23-24","DOIUrl":"https://doi.org/10.21037/ales-23-24","url":null,"abstract":"Background and Objective: The use of robot technology has greatly expanded the field of general surgery. While robot technology has become almost standard for many general surgeons, there is an increasing interest in how this same technology may be utilized within more specialized fields. We sought to explore the advances and current uses of robot technology within the field of vascular surgery. We evaluated this topic broadly in the context of both open and endovascular approaches.","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kunzah A. Syed, Mako Koseki, Sera Satoi, Erica Park, Priya Simoes, Makoto Nishimura
: The endoscopic treatment of neoplastic colorectal lesions has evolved over time to include technically challenging methods such as endoscopic submucosal dissection (ESD), which is slowly gaining traction in the U.S. after relatively widespread implementation in Japan. This review broadly covers the utility and main characteristics of several modalities for the endoscopic diagnosis and treatment of colorectal polyps including white light imaging (WLI), chromoendoscopy, and narrow band imaging (NBI). The increasing utilization of these techniques has unearthed a need for comprehensive and accurate classification systems of assessment, such as Kudo’s pit pattern, the Paris classification, NBI International Colorectal Endoscopic (NICE) classification, and the more recent Japan NBI Experts Team (JNET) classification. The inception and current impact of magnifying endoscopy is also considered, as it has transformed the endoscopist’s ability to inspect microsurfaces and critically evaluate mucosal microstructures to attain an endoscopic prediagnosis. Though there are many clear advantages to existing methods of optical diagnosis, this space has not been devoid of potential problems, and the benefits as well as shortcomings are described herein. The current literature surrounding some promising applications of artificial intelligence (AI) in the detection and management of polyps, as well as in the screening of colorectal cancer (CRC), is also discussed.
{"title":"Colon polyp characterization (morphology and mucosal patterns): clinical application and techniques","authors":"Kunzah A. Syed, Mako Koseki, Sera Satoi, Erica Park, Priya Simoes, Makoto Nishimura","doi":"10.21037/ales-23-10","DOIUrl":"https://doi.org/10.21037/ales-23-10","url":null,"abstract":": The endoscopic treatment of neoplastic colorectal lesions has evolved over time to include technically challenging methods such as endoscopic submucosal dissection (ESD), which is slowly gaining traction in the U.S. after relatively widespread implementation in Japan. This review broadly covers the utility and main characteristics of several modalities for the endoscopic diagnosis and treatment of colorectal polyps including white light imaging (WLI), chromoendoscopy, and narrow band imaging (NBI). The increasing utilization of these techniques has unearthed a need for comprehensive and accurate classification systems of assessment, such as Kudo’s pit pattern, the Paris classification, NBI International Colorectal Endoscopic (NICE) classification, and the more recent Japan NBI Experts Team (JNET) classification. The inception and current impact of magnifying endoscopy is also considered, as it has transformed the endoscopist’s ability to inspect microsurfaces and critically evaluate mucosal microstructures to attain an endoscopic prediagnosis. Though there are many clear advantages to existing methods of optical diagnosis, this space has not been devoid of potential problems, and the benefits as well as shortcomings are described herein. The current literature surrounding some promising applications of artificial intelligence (AI) in the detection and management of polyps, as well as in the screening of colorectal cancer (CRC), is also discussed.","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":"131 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Monika K. Masanam, Danielle A. Grossman, Jacob Neary, Yewande R. Alimi
Background and Objective: Obesity and its associated chronic medical conditions such as diabetes and hypertension are among the leading health concerns in the developed world. Bariatric and metabolic surgery has emerged as an established and definitive treatment for severe obesity. Given the disproportionate burden of obesity and diabetes on different racial and socioeconomic populations, studies have assessed the impact of these disparities in bariatric surgery patients.
{"title":"Disparities in the impact of access to and outcomes of bariatric surgery among different ethnoracial and socioeconomic populations: a narrative review of the literature","authors":"Monika K. Masanam, Danielle A. Grossman, Jacob Neary, Yewande R. Alimi","doi":"10.21037/ales-22-81","DOIUrl":"https://doi.org/10.21037/ales-22-81","url":null,"abstract":"Background and Objective: Obesity and its associated chronic medical conditions such as diabetes and hypertension are among the leading health concerns in the developed world. Bariatric and metabolic surgery has emerged as an established and definitive treatment for severe obesity. Given the disproportionate burden of obesity and diabetes on different racial and socioeconomic populations, studies have assessed the impact of these disparities in bariatric surgery patients.","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Retnagowri Rajandram, Tak Loon Khong, Nora Abdul Aziz, Mohamed Rezal Abdul Aziz, April Camilla Roslani
Background and Objective: Complete mesocolic excision (CME) is thought to achieve better oncological outcomes in colon cancer surgery, but adoption in right-sided colon resections has not been as complete as total mesorectal excision (TME) in rectal cancers, and the technique is not as standardized. In addition, higher rates of intra-operative complications in early studies have limited its wide-scale adoption in routine surgical practice. We aim to determine if the literature supports a universal or selective application of CME in right-sided colonic cancer resections.
{"title":"A narrative review: complete mesocolic excision in right-sided colonic cancer resections—present paradigm and future directions","authors":"Retnagowri Rajandram, Tak Loon Khong, Nora Abdul Aziz, Mohamed Rezal Abdul Aziz, April Camilla Roslani","doi":"10.21037/ales-23-4","DOIUrl":"https://doi.org/10.21037/ales-23-4","url":null,"abstract":"Background and Objective: Complete mesocolic excision (CME) is thought to achieve better oncological outcomes in colon cancer surgery, but adoption in right-sided colon resections has not been as complete as total mesorectal excision (TME) in rectal cancers, and the technique is not as standardized. In addition, higher rates of intra-operative complications in early studies have limited its wide-scale adoption in routine surgical practice. We aim to determine if the literature supports a universal or selective application of CME in right-sided colonic cancer resections.","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":"306 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
: Minimally invasive surgery (MIS) in ulcerative colitis (UC) remains an important part of the surgical arsenal despite advances in biologic treatments for UC. There remains a need for operative intervention in approximately 30% of patients, even with advanced medical therapies. Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the preferred surgery for UC patients with medically refractory disease, refractory bleeding, or dysplasia/cancer. As in most surgical procedures, the move toward MIS has improved overall patient outcomes and UC is no exception. Historically patients have undergone laparotomy for total abdominal colectomy (TAC) and IPAA with the frequent need for multistage surgery as well as multiquadrant abdominopelvic surgery presenting a challenge in the adoption of MIS surgery for UC. However, advances in minimally invasive techniques over the last two decades from hand-assist laparoscopy, to totally laparoscopic surgery, robotic surgery, and transanal approaches have facilitated the gradual move toward MIS. With clear advantages in short-term surgical outcomes including reduced pain, shorter hospital stay, faster return of bowel function, improved cosmesis as well as some potential long-term benefits in bowel function, female fertility, and male sexual function it is clear that MIS for UC is here to stay. Even in an urgent setting with fulminant colitis, laparoscopy is safe and should be preferred over midline laparotomy except in unstable patient. Here, we will discuss the various approaches for MIS surgery in UC including potential advantages and pitfalls of each approach.
{"title":"A review of minimally invasive surgery in ulcerative colitis: more than one way to skin a cat","authors":"Charles Browning, Karen Zaghiyan","doi":"10.21037/ales-23-7","DOIUrl":"https://doi.org/10.21037/ales-23-7","url":null,"abstract":": Minimally invasive surgery (MIS) in ulcerative colitis (UC) remains an important part of the surgical arsenal despite advances in biologic treatments for UC. There remains a need for operative intervention in approximately 30% of patients, even with advanced medical therapies. Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the preferred surgery for UC patients with medically refractory disease, refractory bleeding, or dysplasia/cancer. As in most surgical procedures, the move toward MIS has improved overall patient outcomes and UC is no exception. Historically patients have undergone laparotomy for total abdominal colectomy (TAC) and IPAA with the frequent need for multistage surgery as well as multiquadrant abdominopelvic surgery presenting a challenge in the adoption of MIS surgery for UC. However, advances in minimally invasive techniques over the last two decades from hand-assist laparoscopy, to totally laparoscopic surgery, robotic surgery, and transanal approaches have facilitated the gradual move toward MIS. With clear advantages in short-term surgical outcomes including reduced pain, shorter hospital stay, faster return of bowel function, improved cosmesis as well as some potential long-term benefits in bowel function, female fertility, and male sexual function it is clear that MIS for UC is here to stay. Even in an urgent setting with fulminant colitis, laparoscopy is safe and should be preferred over midline laparotomy except in unstable patient. Here, we will discuss the various approaches for MIS surgery in UC including potential advantages and pitfalls of each approach.","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karan Sachdeva, Lovekirat Dhaliwal, Prasad G. Iyer
: Esophageal cancer is the eighth most common cancer in the world, with high mortality rates. The two main histological subtypes of esophageal cancer are esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC). Both EAC/ESCC are generally preceded by a stepwise progression of precursor metaplastic [Barrett’s esophagus (BE)] and dysplastic lesions, which increase the risk of developing cancer by several folds. Despite advances in management techniques, esophageal cancer continues to have a grim prognosis because it is often detected after the emergence of alarm symptoms. This highlights the need for intensive screening and surveillance with an aim to detect precursor lesions and early-stage esophageal cancer. Multiple international society guidelines recommend screening high-risk populations for BE/EAC, but ESCC screening is not widely recommended. Endoscopic screening remains the gold standard but is not feasible for large-scale application due to associated cost, invasiveness, and required expertise. Ongoing innovations in developing minimally invasive non-endoscopic screening tools combined with molecular biomarkers have fueled further interest in screening and surveillance of high-risk populations. Advanced endoscopic imaging techniques help enhance the surveillance-based detection of precursor lesions, guide targeted tissue acquisition, and stratify the risk of progression to advanced dysplasia/cancer. Multimodal endoscopic eradication therapies have been shown to eradicate dysplasia and reduce progression to EAC/ESCC with minimal adverse effects. Future implementation of minimally invasive screening tools, identification of the prognostic clinical and biomarker tools and adherence to the quality metrics for BE detection will potentially result in significant improvement in the mortality and morbidity related to esophageal cancer.
{"title":"Detection and surveillance of neoplastic lesions of the esophagus: application of guidelines and techniques","authors":"Karan Sachdeva, Lovekirat Dhaliwal, Prasad G. Iyer","doi":"10.21037/ales-23-11","DOIUrl":"https://doi.org/10.21037/ales-23-11","url":null,"abstract":": Esophageal cancer is the eighth most common cancer in the world, with high mortality rates. The two main histological subtypes of esophageal cancer are esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC). Both EAC/ESCC are generally preceded by a stepwise progression of precursor metaplastic [Barrett’s esophagus (BE)] and dysplastic lesions, which increase the risk of developing cancer by several folds. Despite advances in management techniques, esophageal cancer continues to have a grim prognosis because it is often detected after the emergence of alarm symptoms. This highlights the need for intensive screening and surveillance with an aim to detect precursor lesions and early-stage esophageal cancer. Multiple international society guidelines recommend screening high-risk populations for BE/EAC, but ESCC screening is not widely recommended. Endoscopic screening remains the gold standard but is not feasible for large-scale application due to associated cost, invasiveness, and required expertise. Ongoing innovations in developing minimally invasive non-endoscopic screening tools combined with molecular biomarkers have fueled further interest in screening and surveillance of high-risk populations. Advanced endoscopic imaging techniques help enhance the surveillance-based detection of precursor lesions, guide targeted tissue acquisition, and stratify the risk of progression to advanced dysplasia/cancer. Multimodal endoscopic eradication therapies have been shown to eradicate dysplasia and reduce progression to EAC/ESCC with minimal adverse effects. Future implementation of minimally invasive screening tools, identification of the prognostic clinical and biomarker tools and adherence to the quality metrics for BE detection will potentially result in significant improvement in the mortality and morbidity related to esophageal cancer.","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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