PDF(Pubmed)
Abstract：
The continuous evolution of endoscopic tools over the years has paved the way for minimally invasive alternatives to surgical procedures for multiple gastrointestinal conditions. While few endoscopic techniques have supplanted their surgical counterparts like percutaneous gastrostomy tubes, many have emerged as noninferior, less morbid alternatives for such diverse conditions as achalasia (peroral endoscopic myotomy), obesity (endoscopic sleeve gastroplasty), drainage of pancreatic walled off necrosis (EUS-guided cystogastrostomy), and gastric outlet obstruction (EUS-guided gastrojejunostomy). These techniques were based on surgical concepts and would not have been feasible without collaboration between surgeons and endoscopists. Such collaboration is exemplified by the antireflux fundoplication, which features combined hiatal hernia repair with transoral and incisionless fundoplication. The burgeoning armamentarium of endoscopic alternatives to traditional surgical procedures requires a multidisciplinary discussion and individually tailored treatment plans that consider patient preferences as well as the relative risks and benefits of surgical and endoscopic approaches. As technological advances give rise to ever more innovative endoscopic techniques, studies to evaluate clinical outcomes and define their role in treatment algorithms will be required.
摘要：
多年来内窥镜工具的不断发展为多种胃肠道疾病的外科手术的微创替代方案铺平了道路。虽然很少有内窥镜技术取代了像经皮胃造口术这样的外科手术，许多人已经成为非劣质的，对于门失弛缓症（经口内镜肌切开术）等多种疾病，病态较少，肥胖（内窥镜套管胃成形术），胰壁坏死引流（EUS引导下膀胱胃造口术），和胃出口梗阻（EUS引导下的胃空肠造口术）。这些技术基于手术概念，如果没有外科医生和内窥镜医师之间的合作，这些技术是不可行的。这种合作的例子是抗反流胃底折叠术，其特点是食管裂孔疝修补术联合经口和无切口胃底折叠术。内窥镜替代传统外科手术的新兴设备需要进行多学科讨论和个性化的治疗计划，以考虑患者的偏好以及手术和内窥镜方法的相对风险和收益。随着技术进步产生了越来越多的创新内窥镜技术，需要进行研究以评估临床结果并确定其在治疗算法中的作用.
