Released on Apr 6, 2018

New recommendations for endoscopic eradication therapy in Barrett’s esophagus and more in April issue of GIE: Gastrointestinal Endoscopy

Downers Grove, Ill – April 6, 2018-- The latest issue of GIE: Gastrointestinal Endoscopy, the official journal of the American Society for Gastrointestinal Endoscopy (ASGE), includes a new society guideline on use of endoscopic eradication therapy Barrett’s esophagus. Also in this month’s journal, highlighted studies include “Randomized trial of cholangioscopy-guided laser lithotripsy versus conventional therapy for large bile duct stones” and “Increase in female faculty in ASGE-sponsored programming over time.”

Guideline: Endoscopic eradication therapy for patients with Barrett’s esophagus-associated dysplasia and intramucosal cancer

A new guideline by the ASGE Standards of Practice Committee offers evidence-based recommendations and clinical guidelines addressing key issues related to Endoscopic Eradication Therapy (EET) in the management of Barrett’s esophagus (BE)-related lesions.

BE is a condition in which the normal lining of the esophagus develops abnormal lesions, sometimes due to chronic gastroesophageal reflux disease (GERD). It has been identified as a precursor to esophageal adenocarcinoma (EAC), a type of cancer that continues to become more common. In 2014, there were approximately 18,170 incident cases of esophageal cancer in the United States, nearly 60 percent of which were EAC. The outlook for patients with EAC has traditionally been poor.

Endoscopic eradication therapy (EET) has significantly changed the management of patients with BE-related lesions and allows a minimally invasive treatment approach that avoids the illness and deaths associated with the surgical procedure of esophagectomy (removal of some or most of the esophagus).

Contemporary EET, supported by published literature, entails endoscopic mucosal resection (EMR) of visible lesions within the Barrett’s segment and ablation (removal) techniques that include radiofrequency ablation (RFA) and cryotherapy.

Studies show that EET can result in complete removal of diseased tissue, leading to disease remission. This procedure is being performed not only at academic and tertiary care centers, but also among community practices.

This document addresses EET vs. surveillance as optimal management strategy for patients with dysplasia (abnormal growth of cells or tissue) and intramucosal EAC; comparison of EET with esophagectomy; the role of EMR and ablation; and recommendations for surveillance after achieving complete removal of lesions.

Study: Cholangioscopy-guided laser lithotripsy can avoid need for surgery for large bile duct stones

A newer endoscopic therapy, cholangioscopy-guided laser lithotripsy, is being used to replace or enhance more traditional methods of removing bile duct stones larger than 1 cm. A study in the April issue of GIE: Gastrointestinal Endoscopy provides the first randomized trial data on usefulness of this practice.

In the study of 60 patients, 93 percent of those treated with cholangioscopy-guided laser lithotripsy had their stones cleared, compared with 67 percent of those treated only with conventional therapies. Conventional therapies include mechanical lithotripsy and sphincterotomy with balloon dilation.

There was no significant difference in number of procedures needed or adverse events between the two groups. While cholangioscopy-guided laser lithotripsy decreased the need for surgery compared with conventional therapy alone, it is associated with longer procedure times.

Study: Trend of more female faculty in ASGE programming reflects the organization’s culture of increasing diversity

Females are typically underrepresented in senior leadership roles in medicine.  But a new study in GIE: Gastrointestinal Endoscopy found that for educational programs presented by the American Society for Gastrointestinal Endoscopy, the proportion of women faculty increased in recent years, exceeding the rate of growth in female membership for the organization.

Although females represent an increasing percentage of medical trainees, women currently hold fewer leadership positions in the field of medicine than men do. National recognition, including serving as course faculty, is an important factor in academic advancement for physicians. The ASGE study looked at the rate of female domestic membership from 2009 to 2014 and compared it with the rate of increase for female faculty of ASGE courses.

During that time period, the percentage of domestic ASGE members who were female increased from 9.6 percent to 17.5 percent. Over the same period, female faculty in ASGE courses rose from 15 percent to 22 percent. There also was a corresponding increase in course leadership positions for women, such as course director. There were a total of 2,020 faculty positions for ASGE courses.

The authors concluded that these findings may reflect the availability of diverse ASGE programming; exposure for female members to other female mentors within the organization; and an increased national focus on successful early career mentoring efforts for women.  


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About Gastrointestinal Endoscopy
Gastrointestinal endoscopic procedures allow the gastroenterologist to visually inspect the upper gastrointestinal tract (esophagus, stomach and duodenum) and the lower bowel (colon and rectum) through an endoscope, a thin, flexible device with a lighted end and a powerful lens system. Endoscopy has been a major advance in the treatment of gastrointestinal diseases. For example, the use of endoscopes allows the detection of ulcers, cancers, polyps and sites of internal bleeding. Through endoscopy, tissue samples (biopsies) may be obtained, areas of blockage can be opened and active bleeding can be stopped. Polyps in the colon can be removed, which has been shown to prevent colon cancer.

About the American Society for Gastrointestinal Endoscopy
Since its founding in 1941, the American Society for Gastrointestinal Endoscopy (ASGE) has been dedicated to advancing patient care and digestive health by promoting excellence and innovation in gastrointestinal endoscopy. ASGE, with more than 15,000 members worldwide, promotes the highest standards for endoscopic training and practice, fosters endoscopic research, recognizes distinguished contributions to endoscopy, and is the foremost resource for endoscopic education. Visit www.asge.org and www.screen4coloncancer.org for more information and to find a qualified doctor in your area.

American Society for Gastrointestinal Endoscopy
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P (630) 573-0600
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 www.asge.org
 www.screen4coloncancer.org

Media Contact

Gina Steiner
Director of Communications
630.570.5635;gsteiner@asge.org