Asociaţia chirurgilor “Nicolae Anestiadi” din Republica Moldova
Abstract
LOCOD, St. Petersburg, Russia, Al XIII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” și
al III-lea Congres al Societății de Endoscopie, Chirurgie miniminvazivă și Ultrasonografie ”V.M.Guțu” din Republica MoldovaIntroduction: Non-neoplastic disorders of the esophagus amount 89-92% of all diseases of the esophagus, these include various
esophagitis, diverticula of different localization, stricture of the esophagus and esophageal motility disorders (Mozheiko M.A. et al.
2018). Esophageal neoplasms are divided into benign (5%) and malignant (95%).
Aim: Demonstrate the possibilities of endoscopy in the diagnosis and treatment of esophageal disorders.
Materials and methods: Modern endoscopic diagnostics includes examination not only in white light, but also light and electronic
filters that are used to improve the image and examine the vascular pattern (NBI, ISCAN). If necessary, the study can be supplemented
with chromoscopy (Lugol's solution, 1% - acetic acid), which will allow to detailed assessment of the mucosal surface and identify
pathological lesions. During the esophagoscopy, it is possible to take material for cytological or histological examination, which is
necessary for making a diagnosis. Treatment options for Barrett's esophagus include: argon plasma ablation, resection of foci or
radiofrequency ablation. Endoscopic antireflux mucosectomy of the cardiac mucosa is possible at cardiac insufficiency. Benign
mucosal neoplasms are possible to remove using loop resection, cap resection of the formation or dissection in the submucosal
layer. The first stage with malignant neoplasms is performed EUS to assess the degree of invasion, as well as the presence of
regional lymphadenopathy. T1aN0M0 cancer is dissected in the submucosal layer, intraluminal photodynamic therapy is also possible.
Neoplasms in the submucosal layer are used submucosal tunneling resection techniques. Achalasia cardia are treated with using
dilatation or oral myotomy. Zenker's diverticulum are treated with using diverticuloesophagostomy, and also there is tunneling resection
techniques that can be possible.
Results: In Oncology Dispensary of Leningrad Regional since 2016 RFA was performed for 27 patients with Barrett's esophagus with
dysplasia of various degrees. Endoscopic antireflux mucosectomy of the cardiac mucosa was performed in 4 patients.
Conclusions: Endoscopic resection of the esophageal mucosa lesions are performed in 45-50 patients annually. Endoscopic
submucosal dissection of esophageal cancer are performed 10-15 patients annually. Submucosal tunneling resection techniques
performed 4-5 patients per year