Endoscopy and Surgical Oncology

Endoscopic therapy has emerged as a highly effective and minimally invasive way to control and cure early neoplasia of the digestive tract. Polypectomy has been a major advance, and most recently ablation and endoscopic mucosal resection seem to be highly successful in treating flat neoplastic areas involving the gut mucosa. The use of endoscopic ultrasonography (EUS) has resulted in improved accuracy for cancer staging, and EUS-guided fine-needle aspiration has been successful in obtaining tissue diagnosis outside the gut lumen. In advanced cancer, usually managed by multidisciplinary teams of oncologists, surgeons, and radiologists, the gastrointestinal endoscopist (GI) has assumed a key role not only in diagnosis but in palliation with the use of stents to bridge GI obstruction, ablation and the placement of tubes for drainage and feeding.