Endoscopic treatment of upper gastrointestinal tumors.

The art and science of gastrointestinal endoscopy will continue to evolve at an amazing pace, with both endoscopists and industry providing new techniques and technologies for us to learn, investigate and apply to the benefit of our patients. It is not difficult to imagine that the next decade may see the maturation of a distinct specialty of gastrointestinal endoscopic surgery, currently in its adolescence, which crosses traditional boundaries. Practitioners will originate from a variety of backgrounds--gastroenterological, surgical or radiological--but must be trained specifically to perform the wide range of endoscopic procedures already in existence and those continually being introduced. Such 'endotherapists' will be an integral part of multidisciplinary units where optimal management strategies are planned based on available scientific evaluation of techniques irrespective of who performs them. Currently, numerous gastroinestinal diseases including both benign and malignant conditions have been managed using only endoscopic measurements. Control of gastrointestinal bleeding (variceal and non-variceal), dilation of benign and malignant strictures, antireflux management for esophagogastric reflux, endoscopic curative resection of premalignant and malignant lesions, treatment of submucosal tumors, percutaneous endoscopic gastrostomy or jejunostomy, stenting for malignant stricture of hollow viscus or pancreaticobiliary diseases, tumor ablation, and removal of biliary or pancreatic duct stones, etc. have been widely performed and various fascinating techniques and instruments have been continuously developed. It would be difficult to handle all of these various treatment modalities in a limited space. In this review we would like to discuss the fields of gastrointestinal tumors.