Endoscopic management of esophageal and gastric lesions with underlying varices

• Type: Another Publication in an International Scientific Journal
• Date: 2022

Authors

Dias, E (Author) Other; Marques, M (Author) Other; Macedo G (Author) FMUP

Journal

The Journal is awaiting validation by the Administrative Services.

Title: ANNALS OF GASTROENTEROLOGY

Vol. 35

Pages: 452-461

ISSN: 1108-7471

Publisher: HELLENIC SOC GASTROENTEROLOGY

Indexing

ISI Web of Knowledge - 1 Citation

Scopus - 1 Citation

Other information

Authenticus ID: P-00X-1N7

DOI: 10.20524/aog.2022.0739

Abstract (EN): Recent developments in endoscopic techniques have contributed to establishing endoscopy as an essential tool in the management of different types of esophageal and gastric lesions. However, management of these lesions with underlying varices is challenging, considering the technical difficulties and increased risk of bleeding it entails with current endoscopic techniques. Consequently, most endoscopists are hesitant to use this technically challenging procedure. Nevertheless, rare cases of successful endoscopic resection of superficial lesions on or adjacent to varices have been reported. Several endoscopic techniques, including endoscopic mucosal resection, endoscopic submucosal dissection or radiofrequency ablation, have demonstrated safety and feasibility in this setting, sometimes with technical modifications, or in combination with previous variceal eradication procedures that aim to decrease the risk of bleeding. In this review, we summarize the current evidence regarding endoscopic management of gastroesophageal lesions in patients with portal hypertension and underlying varices. It appears that liver cirrhosis, portal hypertension and gastroesophageal varices are not absolute contraindications in selected patients at specialized referral centers. Nevertheless, specific recommendations are lacking and further studies are needed to define the most appropriate endoscopic techniques and to determine which patients may be the best candidates.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 10