Gastrointestinal endoscopy clinics of North America
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Gastrointest. Endosc. Clin. N. Am. · Apr 2012
ReviewEndoscopic ultrasonography/fine-needle aspiration and endobronchial ultrasonography/fine-needle aspiration for lung cancer staging.
This article reviews different techniques available for diagnosis and staging of patients with non-small cell lung cancer (NSCLC). The advantages and disadvantages of each staging method are highlighted. The role of the gastroenterologist in NSCLC staging is explored. A new algorithm is proposed for the staging of NSCLC that incorporates endoscopic and endobronchial ultrasonography for mediastinal staging in patients with intrathoracic disease.
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Gastrointest. Endosc. Clin. N. Am. · Apr 2012
ReviewEndoscopic ultrasound-guided celiac neurolysis.
Intractable abdominal pain commonly develops in patients with pancreatic cancer. Oral pharmacologic therapy is ineffective for many patients and side effects commonly occur. Celiac neurolysis (CN) is sometimes performed to enhance pain relief. ⋯ There is uncertainty regarding the efficacy and role of CN in managing pancreatic cancer pain, but CN should still be considered in this difficult-to-treat cohort of patients. EUS-guided approaches may be favored when EUS is otherwise indicated for diagnostic or staging purposes. When EUS is not otherwise indicated, percutaneous approaches are likely favored.
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Gastrointest. Endosc. Clin. N. Am. · Apr 2012
ReviewEndoscopic ultrasound-guided fiducial markers and brachytherapy.
Endoscopic ultrasound (EUS)-guided needle placement of small radiopaque particles paves the way for EUS-guided fiducial markers and brachytherapy. Stereotactic body radiation therapy relies on image-guided radiation therapy (IGRT), permitting escalation of radiation dose to tumors while minimizing dose to normal tissues. ⋯ Both require precise and minimally-invasive seed placement, which EUS provides. This article reviews recent literature regarding the safety and efficacy of these procedures and discusses novel concepts, including EUS-guided celiac ganglia radiation neurolysis.
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Abdominal and pelvic abscesses have traditionally been drained by percutaneous techniques or surgery. While surgical drainage is associated with considerable morbidity and mortality, percutaneous techniques are associated with the need for multiple interventions, increased length of hospital stay, and an indwelling external catheter for prolonged periods. ⋯ Although data are limited, evidence supporting its clinical efficacy is increasing rapidly. This article summarizes the current status of EUS-guided approach for drainage of gastrointestinal abscess collections.