Intraluminal Endoscopy Research Depertment

Main areas of research and application activities of the Department

• Investigation and scientific justification of the use of minimally-invasive radical methods of treatment of early cancer of the gastrointestinal tract
  Endoscopic mucosal resection and endoscopic submucosal dissection are the current standards of treatment of early cancer of the gastrointestinal tract as per the recommendations of the Japanese Society of Gastroenterology, the Japanese Society for Cancer of the Colon and Rectum and the European Society of Gastrointestinal Endoscopy. Although a common practice in Europe and Japan, these methods are not widely used in Russia. The Department has by far more practical experience of these methods than any other healthcare facility in Saint Petersburg, or even in Russia.
• Investigative endoscopic procedures and treatment of submucosal masses of the gastrointestinal tract
  One of the latest and most promising areas that has been pursued by the Department since 2013 is investigative endoscopic procedures and treatment of submucosal masses of the gastrointestinal tract, such as gastrointestinal stromal tumors, neuroendocrine tumors (carcinoid tumors), leiomyomas, schwannomas and lipomas. Endoscopic ultrasound combined with needle aspiration, which is a modern diagnostic procedure to identify the above neoplasms, is also actively used. The Department has been defining the indications and developing the criteria for endoscopic removal of these neoplasms by using tunnel endoscopic resection. The Department of Endoscopy of the N.N. Petrov National Medical Research Center of Oncology is one of the few healthcare facilities that is successfully using this treatment technique. Since they were first introduced into clinical practice, the Department has performed more such procedures than any other healthcare facility in Russia.
• Peroral endoscopic myotomy
  The Department of Endoscopy has been treating rare benign conditions of the esophagus, such as esophageal achalasia and corkscrew esophagus since 2012. Endoscopic surgical treatment of these conditions has proven to be much more effective than traditional endoscopic treatments, such as endoscopy and dilation combined with intramuscular injection of botulinum toxin. Absence of any significant complications or recurrences of the disease make endoscopic surgical treatment a minimally-invasive and radical method of treatment of these conditions.
• Treatment of decompensated and critical neoplastic and benign strictures of the esophagus, stomach, large intestine, trachea and bronchi; enteroenteroanastomosis and esophagogastric anastomosis
  The specialists of the Department perform bougieurage (dilation), balloon dilatation and stenting which can widen the passageway of an organ in more than 90% of all cases. To treat inoperable patients with esophageal cancer, the Department uses a treatment modality that involves the successive use of endoscopic intraluminal surgery with combined radiotherapy (intraluminal high-dose brachytherapy + external-beam radiotherapy), which allows to achieve a significant local effect in 80% of all cases.
• Treatment of locally advanced non-small cells central lung cancer
  The Department continues to contribute to its joint effort with the Thoracic Surgery Department to treat locally advanced non-small cells central lung cancer. The step-by-step successive use of photodynamic therapy and brachytherapy allows to reduce the volume of tumor masses and ‘restage’ a cancer, making surgical treatment a viable treatment option in the future.
• Diagnosis and treatment of premalignancies of the gastrointestinal tract
  One of the main focuses of the research and clinical activities of the Department is the diagnosis and treatment of premalignancies of the gastrointestinal tract, such as Barrett's esophagus, and gastric and large intestine polyps. The Department is in the process of implementing a colon and rectal cancer screening program that is in compliance with the standards used in most European countries.
• Endoscopic ultrasound
  The Department performs 3-6 diagnostic endoscopies daily. Ежедневно специалистами нашего отделения выполняется от 3 до 6 диагностических процедур. Diagnostic endoscopies allow a doctor to: - diagnose submucosal masses of the esophagus, stomach and duodenum, and to collect more detailed information on their site and growth; - to stage early forms of upper gastrointestinal and rectal cancer to select a most effective treatment plan; - to stage prevalent forms of esophageal cancer before pre-surgery chemotherapy and radiation therapy and after the end of the treatment to assess the degree of tumor regression; - to scan the pancreaticobiliary organs to make a differential diagnosis of tumor and inflammation diseases of the pancreas, liver and bile ducts. In addition to its diagnostic use, the state-of-the-art echoendoscope featuring a curved linear array transducer also allows to perform a number of treatment procedures, such as aspiration of lesions and cysts of the pancreas and lymph nodes to examine the neoplastic processes and сeliac plexus neurolysis as part of the palliative care offered to patients with chronic pain.

The Department of Endoscopy works closely with many clinical departments of the Center to ensure a multidisciplinary approach to treatment of patients. The specialists of the Department provide endoscopic assistance during thoracic and abdominal surgeries and help to prevent immediate complications after low anterior resection of the rectum, esophagus and stomach. If a patient cannot take food and water through their mouth in cases of mouth, laryngeal, pharynx and esophageal cancers, the specialists of the Department will perform an insertion of a nasogastric feeding tube or a nasoenteric feeding tube, or percutaneous endoscopic gastrostomy.