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The rising incidence of esophageal adenocarcinoma has stimulated interest in screening for Barrett's esophagus, but there is no proof that screening decreases esophageal cancer mortality. This Viewpoint argues that, on the basis of the available evidence, screening is beneficial, and that it is better to err on the side of caution and perform unnecessary screening rather than miss curable cancers.
Partial liver resection alone is not able to cure a substantial number of patients who have liver tumors. Thermoablation expands the therapeutic modalities available to these patients by using heat (radiofrequency ablation) or cold (cryoablation) to achieve tumor necrosis. This Viewpoint discusses the evidence for using these two ablative modalities in clinical practice and suggests that radiofrequency ablation is the superior approach.
The authors of this Review discuss the diagnosis, clinical features and genetics of the hamartomatous polyposis syndromes, as well as the risk of malignancy associated with each syndrome and appropriate surveillance recommendations. Other disorders associated with the presence of hamartomatous polyps are briefly discussed, along with the potential for targeted therapy of hamartomatous polyposis syndromes.
Over the past 15 years, intestinal transplantation for the treatment of intestinal failure has changed from a desperate last-ditch effort into a standard therapy for which a good outcome is expected. In this Review, the author considers several issues surrounding intestinal transplantation, including patient selection, allograft type, outcomes, complications, post-transplant monitoring and cost.
This Review considers the role of endoscopic submucosal dissection as a treatment for early-stage gastrointestinal neoplasms. The author focuses on what is required for endoscopic submucosal dissection to be successful, safe and reliable—early detection, accurate preoperative diagnosis, a thorough knowledge of appropriate indications and techniques, and appropriate training.
