Description
The "Therapeutic Endoscopy for the Non-Therapeutic Endoscopist" session is designed to provide gastroenterologists who may not regularly perform therapeutic procedures with valuable insights and hands-on skills in therapeutic endoscopy. This session focuses on practical aspects, including basic techniques for hemostasis, polypectomy, and foreign body removal, allowing participants to gain proficiency in therapeutic interventions. By bridging the gap between routine endoscopy and therapeutic procedures, this session aims to empower non-therapeutic endoscopists with the necessary knowledge and skills to enhance their clinical practice and contribute to comprehensive patient care within the field of Gastroenterology.
Résumé
- The talk focuses on the management of polyps discovered during endoscopy, particularly for endoscopists who aren't specialized in advanced techniques. It emphasizes understanding available options, primarily EMR (endoscopic mucosal resection) and ESD (endoscopic submucosal dissection), highlighting ESD's lower recurrence rate and ability to assess submucosal invasion.
- EMR targets the mucosal layer, while ESD dissects deeper into the submucosa, enabling on-block resection and accurate histopathologic assessment. The speaker advocates endoscopic resection as superior to surgery due to lower mortality and morbidity rates. ESD is particularly suited for early cancers, dysplastic lesions, equivocal histology, and fibrotic lesions.
- Optical diagnosis is crucial, using Paris and NICE classifications to assess submucosal invasion risk. LSTs (laterally spreading tumors) are classified based on granular and nodular characteristics, correlating with invasion probability. NICE classification aids in differentiating between benign and potentially malignant polyps using NBI (narrow band imaging).
- Tattooing is described to localized an injection after lifting a polyp. Multiple planes for potential malignancy, or a single distal tattoo for future surveillance and scar localization.
- Biopsies should be reserved for suspected cancers, ulcerated areas, or nodules on flat polyps, avoiding unnecessary biopsies on polyps intended for referral. Good documentation, including pictures and videos, is critical when referring to advanced endoscopists.
Exemple de certificat
À propos des intervenants
Dr. Sarah Al Ghamdi
Professeur adjoint de médecine, gastro-entérologue et endoscopiste avancé, Université du Roi Abdulaziz, Djeddah, Arabie saoudite
Divulgation financière
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