Endoscopic management of gastrointestinal cancer and precancerous conditions [Testoni; Arcidiacono; Mariani - Minerva Medica]

In the last two decades digestive endoscopy has played a pivotal role in the management of gastrointestinal tumors; in more recent years the development of advanced imaging technologies and new devices for endoluminal therapy has markedly expanded both diagnostic and therapeutic indications for endoscopy in gastroenterological oncology. Prevention of gastrointestinal tumors is today feasible by colonoscopy-based screening programs and follow-up of precancerous cnditions, with a significant positive impact on cancer-related mortality. Advanced imaging technologies identify neoplasia at a very early stage and may give real time histology. New technologically-advanced devices and materials allow endoluminal therapy to treat lesions that until few years ago could only be treated by surgery, with significant improvement in hospital costs and patients morbidity, besides a significant cost-saving for the health care system, if routinely adopted in clinical practice outside referral centers. Palliation by endoscopy has a lower complication rate, compared to surgery, and improves the quality of life of patients permitting to start chemo-/radiotherapy earlier than after surgery. Moreover, the progressive diffusion of ultrasound endoscopy in the last years had a tremendous impact in the clinical management of gastrointestinal neoplasia, allowing a proper selection of patients suitable for curative endoscopic resection, or by-pass procedures not feasible by standard endoscopy. In this book, unique for its completeness and specificity, we have brought together the world’s top experts and asked them to address all aspects, present and future, of the endoscopic management of digestive tumors, from the advanced diagnostics to therapy, with the aim of providing the reader with the state of the art in the field and future perspectives.