Skip to main content

14.05.2024

Tips and Thought Processes to Overcome Difficult Situations in Third Space Endoscopy

verfasst von: Amit Maydeo, Nagesh Kamat, Gaurav Patil, Ankit Dalal, Amol Vadgaonkar, Sanil Parekh

Erschienen in: Current Gastroenterology Reports

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

Third space endoscopy (TSE) offers diverse treatment options for a variety of conditions of the gastrointestinal tract and motility disorders. Accuracy and precise dissection have helped treat complex conventional surgeries with TSE. Despite over a decade of its presence, difficult situations are routinely encountered.

Recent Findings

The first challenging situation is decision-making (before the procedure), the second is tackling procedure-induced pulmonary / insufflation-related adverse events and intra-operative complications (during the procedure), and the third is post-operative complications and morbidity (post-procedure).

Summary

The performance of TSE procedures is not without risk. Patients should receive enough time to weigh their options, considering that attitudes toward risk impact decision-making. Continuous basic patient monitoring and the micro-movements of endoscopic and electrosurgical equipment is crucial to avoid accidental injury. Anaesthetists should be mindful of anticipated complications and closely monitor, diagnose, and treat them. Demanding situations need careful consideration, problem-solving, or persistence to overcome challenges. This brief review provides inputs on preventing and tackling difficult situations in TSE.
Literatur
1.
Zurück zum Zitat Inoue H, Maydeo A. Peroral endoscopic myotomy (POEM) opens the door of third-space endoscopy. Endoscopy. 2019;51(11):1010–12.CrossRefPubMed Inoue H, Maydeo A. Peroral endoscopic myotomy (POEM) opens the door of third-space endoscopy. Endoscopy. 2019;51(11):1010–12.CrossRefPubMed
2.
Zurück zum Zitat • Patil G, Dalal A, Maydeo A. Early outcomes of peroral endoscopic myotomy with fundoplication for achalasia cardia - is it here to stay? Dig Endosc. 2021;33(4):561–8. (This was a negative study mentioning about short comings of poem with fundoplication).CrossRefPubMed • Patil G, Dalal A, Maydeo A. Early outcomes of peroral endoscopic myotomy with fundoplication for achalasia cardia - is it here to stay? Dig Endosc. 2021;33(4):561–8. (This was a negative study mentioning about short comings of poem with fundoplication).CrossRefPubMed
3.
Zurück zum Zitat Feng X, Linghu E, Chai N, Ding H. New endoscopic classification of esophageal mucosa in achalasia: a predictor for submucosal fibrosis. Saudi J Gastroenterol. 2018;24(2):122–8.CrossRefPubMedPubMedCentral Feng X, Linghu E, Chai N, Ding H. New endoscopic classification of esophageal mucosa in achalasia: a predictor for submucosal fibrosis. Saudi J Gastroenterol. 2018;24(2):122–8.CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Tanaka S, Kawara F, Toyonaga T, et al. Two penetrating vessels as a novel indicator of the appropriate distal end of peroral endoscopic myotomy. Dig Endosc. 2018;30(2):206–11.CrossRefPubMed Tanaka S, Kawara F, Toyonaga T, et al. Two penetrating vessels as a novel indicator of the appropriate distal end of peroral endoscopic myotomy. Dig Endosc. 2018;30(2):206–11.CrossRefPubMed
5.
Zurück zum Zitat Tanaka S, Toyonaga T, Kawara F, et al. Novel per-oral endoscopic myotomy method preserving oblique muscle using two penetrating vessels as anatomic landmarks reduces postoperative gastroesophageal reflux. J Gastroenterol Hepatol. 2019;34(12):2158–63.CrossRefPubMed Tanaka S, Toyonaga T, Kawara F, et al. Novel per-oral endoscopic myotomy method preserving oblique muscle using two penetrating vessels as anatomic landmarks reduces postoperative gastroesophageal reflux. J Gastroenterol Hepatol. 2019;34(12):2158–63.CrossRefPubMed
6.
Zurück zum Zitat •• Yoo IK, Choi SA, Kim WH, et al. Assessment of clinical outcomes after peroral endoscopic myotomy via esophageal distensibility measurements with the endoluminal functional lumen imaging probe. Gut Liver. 2019;13(1):32–9. (This study highlights esophageal distensibility measurements that help in accurate myotomy at GEJ to have better clinical outcomes).CrossRefPubMed •• Yoo IK, Choi SA, Kim WH, et al. Assessment of clinical outcomes after peroral endoscopic myotomy via esophageal distensibility measurements with the endoluminal functional lumen imaging probe. Gut Liver. 2019;13(1):32–9. (This study highlights esophageal distensibility measurements that help in accurate myotomy at GEJ to have better clinical outcomes).CrossRefPubMed
7.
Zurück zum Zitat Zhang XC, Li QL, Xu MD, et al. Major perioperative adverse events of peroral endoscopic myotomy: a systematic 5-year analysis. Endoscopy. 2016;48(11):967–78.CrossRefPubMed Zhang XC, Li QL, Xu MD, et al. Major perioperative adverse events of peroral endoscopic myotomy: a systematic 5-year analysis. Endoscopy. 2016;48(11):967–78.CrossRefPubMed
8.
Zurück zum Zitat Rodriguez JH, Haskins IN, Strong AT, et al. Per oral endoscopic pyloromyotomy for refractory gastroparesis: initial results from a single institution. Surg Endosc. 2017;31(12):5381–8.CrossRefPubMed Rodriguez JH, Haskins IN, Strong AT, et al. Per oral endoscopic pyloromyotomy for refractory gastroparesis: initial results from a single institution. Surg Endosc. 2017;31(12):5381–8.CrossRefPubMed
9.
Zurück zum Zitat Labonde A, Lades G, Debourdeau A, et al. Gastric peroral endoscopic myotomy in refractory gastroparesis: long-term outcomes and predictive score to improve patient selection. Gastrointest Endosc. 2022;96(3):500–8.CrossRefPubMed Labonde A, Lades G, Debourdeau A, et al. Gastric peroral endoscopic myotomy in refractory gastroparesis: long-term outcomes and predictive score to improve patient selection. Gastrointest Endosc. 2022;96(3):500–8.CrossRefPubMed
10.
Zurück zum Zitat Du C, Chai NL, Ling-Hu EQ, et al. Submucosal tunneling endoscopic resection: an effective and safe therapy for upper gastrointestinal submucosal tumors originating from the muscularis propria layer. World J Gastroenterol. 2019;25(2):245–57.CrossRefPubMedPubMedCentral Du C, Chai NL, Ling-Hu EQ, et al. Submucosal tunneling endoscopic resection: an effective and safe therapy for upper gastrointestinal submucosal tumors originating from the muscularis propria layer. World J Gastroenterol. 2019;25(2):245–57.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Maydeo A, Patil G, Kamat N, et al. Endoscopic full-thickness plication for the treatment of gastroesophageal reflux after peroral endoscopic myotomy: a randomized sham-controlled study. Endoscopy. 2023;55(8):689–98.CrossRefPubMedPubMedCentral Maydeo A, Patil G, Kamat N, et al. Endoscopic full-thickness plication for the treatment of gastroesophageal reflux after peroral endoscopic myotomy: a randomized sham-controlled study. Endoscopy. 2023;55(8):689–98.CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Maydeo A. A good mountaineer is one who knows how to come back safely. Gastrointest Endosc. 2019;89(4):779–81.CrossRefPubMed Maydeo A. A good mountaineer is one who knows how to come back safely. Gastrointest Endosc. 2019;89(4):779–81.CrossRefPubMed
Metadaten
Titel
Tips and Thought Processes to Overcome Difficult Situations in Third Space Endoscopy
verfasst von
Amit Maydeo
Nagesh Kamat
Gaurav Patil
Ankit Dalal
Amol Vadgaonkar
Sanil Parekh
Publikationsdatum
14.05.2024
Verlag
Springer US
Erschienen in
Current Gastroenterology Reports
Print ISSN: 1522-8037
Elektronische ISSN: 1534-312X
DOI
https://doi.org/10.1007/s11894-024-00935-7

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

29.05.2024 Larynxkarzinom Nachrichten

Fast ein Viertel der Personen mit mäßig dysplastischen Stimmlippenläsionen entwickelt einen Kehlkopftumor. Solche Personen benötigen daher eine besonders enge ärztliche Überwachung.

Nach Herzinfarkt mit Typ-1-Diabetes schlechtere Karten als mit Typ 2?

29.05.2024 Herzinfarkt Nachrichten

Bei Menschen mit Typ-2-Diabetes sind die Chancen, einen Myokardinfarkt zu überleben, in den letzten 15 Jahren deutlich gestiegen – nicht jedoch bei Betroffenen mit Typ 1.

15% bedauern gewählte Blasenkrebs-Therapie

29.05.2024 Urothelkarzinom Nachrichten

Ob Patienten und Patientinnen mit neu diagnostiziertem Blasenkrebs ein Jahr später Bedauern über die Therapieentscheidung empfinden, wird einer Studie aus England zufolge von der Radikalität und dem Erfolg des Eingriffs beeinflusst.

Costims – das nächste heiße Ding in der Krebstherapie?

28.05.2024 Onkologische Immuntherapie Nachrichten

„Kalte“ Tumoren werden heiß – CD28-kostimulatorische Antikörper sollen dies ermöglichen. Am besten könnten diese in Kombination mit BiTEs und Checkpointhemmern wirken. Erste klinische Studien laufen bereits.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.