Comparative evaluation of esophageal Barrett's epithelium through esophageal capsule endoscopy and methylene blue chromoendoscopy

Recent Advances in Non-invasive Esophageal Tissue Sampling

PURPOSE OF REVIEW

The costs to society and accuracy of screening for esophageal cancer and other esophageal diseases with standard endoscopy are formidable. As a result, the applicability of endoscopy as a general screening tool has been challenged.

RECENT FINDINGS

To maintain accuracy but reduce the price of endoscopy on society, multiple adjunct or replacement technologies are being developed that are less expensive and more easily applied. These devices include image-enhancing techniques that more reliably identify dysplasia and cancer reducing the need for extensive biopsy sampling during standard endoscopy. They also include ambulatory forms for procuring esophageal imaging including smaller endoscopes and capsule endoscopy. Finally, some of the newer methods either obtain samples of esophageal tissue through bedside maneuvers not requiring endoscopy or retrieve information about mucosal inflammation and function without the need to procure esophageal tissue. There is an exciting future for esophageal diagnosis with tools that will save cost and/or provide greater accuracy and safety for some of the most common esophageal disorders.

Value of screening endoscopy in evaluation of esophageal, gastric and colon cancers

Esophageal, gastric, and colorectal cancers are deadly diseases that continue to plague our world today. The value of screening endoscopy in evaluating these types of cancers is a critical area of discussion due to a potential reduction in morbidity and mortality. This article describes how to identify a good screening test and explains what are important criteria in the field of screening endoscopy. Furthermore, the current status and progress of screening endoscopy for esophageal, gastric, and colorectal cancer will be evaluated and discussed. Mass screening programs have not been implemented for esophageal and gastric carcinomas in those with average or low risk populations. However, studies of high-risk populations have found value and a cost-benefit in conducting screening endoscopy. Colorectal cancer, on the other hand, has had mass screening programs in place for many years due to the clear evidence of improved outcomes. As the role of endoscopy as a screening tool has continued to develop, newer technology and techniques have emerged to improve its utility. Many new image enhancement techniques and computer processing programs have shown promise and may have a significant role in the future of endoscopic screening. These developments are paving the way for improving the diagnostic and therapeutic capability of endoscopy in the field of gastroenterology.

Video capsule endoscopy: Perspectives of a revolutionary technique

Video capsule endoscopy (VCE) was launched in 2000 and has revolutionized direct endoscopic imaging of the gut. VCE is now a first-line procedure for exploring the small bowel in cases of obscure digestive bleeding and is also indicated in some patients with Crohn’s disease, celiac disease, and polyposis syndrome. A video capsule has also been designed for visualizing the esophagus in order to detect Barrett’s esophagus or esophageal varices. Different capsules are now available and differ with regard to dimensions, image acquisition rate, battery life, field of view, and possible optical enhancements. More recently, the use of VCE has been extended to exploring the colon. Within the last 5 years, tremendous developments have been made toward increasing the capabilities of the colon capsule. Although colon capsule cannot be proposed as a first-line colorectal cancer screening procedure, colon capsule may be used in patients with incomplete colonoscopy or in patients who are unwilling to undergo colonoscopy. In the near future, new technological developments will improve the diagnostic yield of VCE and broaden its therapeutic capabilities.