Novel insights into esophageal diagnostic procedures.
The 21st century offers new advances in diagnostic procedures and protocols in the management of esophageal diseases. This review highlights the most recent advances in esophageal diagnostic technologies, including clinical applications of novel endoscopic devices, such as ultrathin endoscopy and confocal laser endomicroscopy for diagnosis and management of Barrett's esophagus; novel parameters and protocols in high-resolution esophageal manometry for the identification and better classification of motility abnormalities; innovative connections between esophageal motility disorder diagnosis and detection of gastroesophageal reflux disease (GERD); impedance-pH testing for detecting the various GERD phenotypes; performance of distensibility testing for better pathophysiological knowledge of the esophagus and other gastrointestinal abnormalities; and a modern view of positron emission tomography scanning in metastatic disease detection in the era of accountability as a model for examining other new technologies. We now have better tools than ever for the detection of esophageal diseases and disorders, and emerging data are helping to define how well these tools change management and provide value to clinicians. This review features novel insights from multidisciplinary perspectives, including both surgical and medical perspectives, into these new tools, and it offers guidance on the use of novel technologies in clinical practice and future directions for research.
Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy. edoardo.savarino@unipd.it.
Edoardo
E
Savarino
Department of Surgical and Diagnostic Integrated Sciences, University of Genoa, Genoa, Italy.
Andrea
A
Ottonello
Division of General and Bariatric Surgery, Department of Surgery, Second University of Naples, Naples, Italy.
Salvatore
S
Tolone
Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
Ottavia
O
Bartolo
Division of Gastroenterology, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, South Korea.
Myong Ki
MK
Baeg
Division of Cardiothoracic Surgery, Surgical Outcomes Research Center, University of Washington, Seattle, Washington.
Farhood
F
Farjah
Department of Gastroenterology and Hepatology, Gunma University Hospital, Maebashi, Japan.
Shiko
S
Kuribayashi
Division of Gastroenterology, Palo Alto Medical Foundation, Mountain View, California.
Katerina P
KP
Shetler
Department of Gastroenterology and Hepatology, Mech-Sense, Aalborg University Hospital, Aalborg, Denmark.|Department of Medicine, North Jutland Regional Hospital, Hjørring, Denmark.
Christian
C
Lottrup
Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland.
Ellen
E
Stein
D015154:Esophageal Motility Disorders / Q000175:diagnosis* / Q000503:physiopathology; D050782:Esophageal pH Monitoring / Q000379:methods / Q000639:trends*; D004945:Esophagoscopy / Q000379:methods / Q000639:trends*; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008365:Manometry / Q000379:methods / Q000639:trends*
GERD; cancer staging; distensibility; esophagus; high-resolution esophageal manometry; impedance; positron emission tomography