VILLA MONASTERO (Symposia)











Attenzione: apre in una nuova finestra.

Symposium 1 Sunday, September 2, 8:00 – 9:45 am
The esophageal mucosa and submucosa
Chairs: R.H. Riddell (Toronto) – M. Upton (Seattle)

  • Which cells normally exist in the esophageal epithelium? What is their function? R.H. Riddell (Toronto)
  • What is the function and role of submucosal mucous glands under the esophageal squamous epithelium? J. Sarosiek (El Paso)
  • Are Dilated Intercellular Spaces (DIS) normal? H.H. Wang (Boston)
  • Why/when do DIS occur? H. El-Zimaity (Toronto)
  • Should GEJ biopsies be taken in patients with reflux in the absence of vible BE? J. Abrams (New York)
  • Do cells in the lamina propria reflect those in the epithelium? H.D. Appelman (Ann Arbor)
  • How are stem cells identified in the squamous esophagus? M. Upton (Seattle)
  • Can stem cells be identified in Barrett’s dysplasia? X. Sagaert (Leuven)
  • What proportion of esophageal stem cells are marrow derived? D. Jain (Yale)
  • What is the origin and significance of multilayered epithelium? M. Vieth (Bayreuth)

The duplicated muscularis mucosae and its implications

  • When/why does duplication of the muscularis mucasae happen? K. Takubo (Tokyo)
  • Are there always 2 layers in BE? – If not, how do we know when are we definitively in the submucosa? C. Streutker (Toronto)
  • What is the function of the muscularis mucosae? X. Sagaert (Leuven)
  • Is the metastasizing potential of early carcinoma dependant on extent of spread through the duplicated muscularis mucosae? S. Abraham (Houston)
  • Does the choice of Endoscopic therapy matter in patients with dysplasia or intramucosal carcinoma R.C. Fitzgerald (Cambridge)
    a)    For initial therapy?
    b)    For subsequent therapy

Symposium 2 Sunday, September 2, 10:15 am - 12:00 pm
Immuno-histology in GERD and Barrett's esophagus
Chairs:
M. Vieth (Bayreuth) – R. Fiocca (Genoa)
Discussant: N.S. Buttar (Rochester, MN)
Secretary: H. Neumann (Erlangen)

  • How does the stroma in BE differ from that of the normal esophagus? R.C. Fitzgerald (Cambridge)
  • How are the epithelial-stromal interactions and signaling pathways altered in association with fibro-muscular anomaly? R.H. Riddell (Toronto)
  • What is the role of tumor suppressor genes, including p16, p14 and p53 in BE? R. Fiocca (Genoa)
  • What is the role of proto-oncogenes in BE, including EGF, EGFR, HER2-neu? R.D. Odze (Boston)
  • How do immuno-histochemical markers differ comparing intestinal/tubular type adenocarcinomas in BE with carcinomas of fundic or signet-cell types? K. Takubo (Tokyo)
  • Does immuno-histochemistry have a role in grading of neoplasia in BE? As a way to define risk of progression to adenoca? M. Upton (Seattle)
  • Is there a combination of molecular tests and/or immuno-histochemistry that can improve management compared with H&E stained biopsies and surveillance? H.D. Appelman (Ann Arbor)
  • What is the role of CDX1 and CDX2 in squamous and cardiac mucosa? A. Bellizzi (Iowa City)
  • What is the role of desmosomal cadherins and lektins in squamous and cardiac mucosa? H. Neumann (Erlangen)

Symposium 3 Sunday, September 2, 2:30 – 4:15 pm
Leaks – Perforations
Stents for benign / malignant strictures

Chairs: K. Dua (Milwaukee) – P. Siersema (Utrecht)
Discussant: B. Wijnhoven (Rotterdam)

  • Are there any predictors of response to endotherapy for corrosive strictures? R. Kochhar(Chandigarh)
  • Should esophageal stents be used for treating benign esophageal strictures? K.S. Dua (Milwaukee)
  • Are biodegradable stents better alternative to removable stents? P. Siersema (Utrecht)
  • Esophageal perforation: conservative management, endotherapy or surgery? K.L. Goh (Kuala Lumpur)
  • Endotherapy for esophageal perforation/leaks: clip, stent, suture, fibrin or combinations? E. DeMoura (Sao Paulo)
  • What determines the optimal stenting period in benign esophageal strictures/leaks? K.L. Goh (Kuala Lumpur)
  • Do esophageal leaks due to surgery/instrumentation/ulcers/spontaneous require different treatment options? N. Reddy (Hyderabad)
  • What strategy to adopt when a fistula of a cervical anastomosis occurs? V.N. Felix (Sao Paulo)
  • Should esophageal leak/fistula communicating with an infected mediastinal cavity be endoscopically closed? If not, what are the alternatives? If yes, should the cavity be drained percutaneously prior to endotherapy? N.M. Guda (Milwaukee)
  • How should new fistula secondary to an esophageal stent be treated? E. DeMoura (Sao Paulo)
  • How can a malignant stricture close to the upper esophageal stricture be palliated? N.M. Guda (Milwaukee)
  • Palliation of malignant dysphagia: How to choose an esophageal stent. K.S. Dua (Milwaukee)
  • Are fully covered expandable stents better than partially covered expandable stents? N. Reddy (Hyderabad)
  • Laser therapy for esophageal strictures M. Häfner (Vienna)
  • Management of esophageal leaks with intra-thoracic endoscopy and Argon plasma A. Nieponice (Buenos Aires)

Symposium 4 Sunday, September 2, 4:30- 6:15 pm
Benign esophageal stenoses
New tools and concepts for management

Chairs: G. Costamagna (Rome) – L.L. Swanström (Portland)
Discussant: P. Siersema (Utrecht)

  • Can barium esophagography detect lower esophageal rings or peptic strictures missed on endoscopy? M.S. Levine (Philadelphia)
  • Are bougie and balloon dilations of benign esophageal strictures similar in efficacy and safety and in what situations one should be preferred over the other? R. Kochhar (Chandigarh)
  • What can be expected from the novel dilator specifically fitted for UES? P. Belafsky (Los Angeles)
  • Does steroid injections into refractory benign esophageal strictures delay their recurrence? If yes, why should it not be used routinely for every benign stricture? P. Siersema (Utrecht)
  • Which esophageal strictures are ideally suited for electrocautery treatment? P. Siersema (Utrecht)
  • Is endotherapy for benign esophageal strictures and perforations delaying and making surgery more difficult? B. Gayet (Paris)
  • Do refractory strictures from different etiologies (radiation, corrosive, post-PDT/ESD, anastomotic) respond differently to endotherapy? E. DeMoura (Sao Paulo)
  • What are the surgical options for benign strictures? K.L. Goh (Kuala Lumpur)
  • How should we manage esophageal webs? K.S. Dua (Milwaukee)
  • How should we manage eosinophilic esophagitis-associated strictures? N.M. Guda (Milwaukee)
  • What is the optimal dose of intra-lesional steroids, the optimal number of sessions of steroid injections, and the best technique of steroid injections? R. Kochhar (Chandigarh)
  • Can the response to stricture dilation be predicted by EUS or CT characteristics? N. Reddy (Hyderabad)
  • Should stenoses following severe esophageal burns be treated by esophageal resection or esophageal by-pass? V.N. Felix (Sao Paulo)
  • The patch esophagoplasty with biological scaffolds for treatment of esophageal strictures. A. Nieponice (Buenos Aires)

Symposium 5 Monday, September 3, 7:45 - 10:00 am
Pediatrics

Chairs:
S.R. Jadcherla (Columbus) – S. Nurko (Boston)
Discussant: M. Chehade (New York)

  • What is the definition of GERD in infants and children? S. Nurko (Boston)
  • What is the natural history of GER and GERD that starts in infants and children? M. Thomson (Sheffield)
  • What are the underlying mechanisms that generate symptoms in GERD in children? N. Tipnis (San Diego)
  • What are the upstream and downstream reflexes that protect against esophageal provocation in infants and children? S.R. Jadcherla (Columbus)
  • How do you evaluate GERD? R. Rosen (Boston)
  • What is the best way to determine symptom association with GER events in infants and children? R. Rosen (Boston)
  • Potential biomarkers for GERD R. Rosen (Boston)
  • What are the non-pharmacological approaches of managing GER and GERD in infants and children? S.R. Jadcherla (Columbus)
  • Benefits and risks of pharmacological approaches in managing GER and GERD in infants and children? M. Thomson (Sheffield)
  • Are the new pediatric GERD guidelines applicable to clinical practice? S. Nurko (Boston)

Symposium 6 Monday, September 3, 10:15 am - 12:00 pm
Eosinophilic esophagitis

Chairs:
R.F. Souza (Dallas) – J.E. Richter (Tampa)
Discussant: S.M. Achem (Jacksonville)

  • What is the definition, prevalence and natural history of EoE? J.E. Richter (Tampa)
  • What is the role of endoscopy in the evaluation of eosinophilic esophagitis? A.J. Lucendo (Ciudad Real)
  • Is EoE a food allergy? M. Chehade (New York)
  • Does a response to PPI therapy distinguish EoE from GERD? R.F. Souza (Dallas)
  • In vivo optical imaging in EoE? K.K. Wang (Rochester, MN)

Symposium 8 Monday, September 3, 4:30 - 6:15 pm
The role of HRM in clinical practice

Chairs:
C.P. Gyawali (St Louis) – R. Tutuian (Bern)
Discussant: J.O. Clarke (Baltimore)

  • The Chicago classification: how does it help? C.P. Gyawali (St Louis)
  • HRM vs HRM + Impedance: a further step forward? F. Zerbib (Bordeaux)
  • Esophageal function: evaluation of reflux mechanisms J. O. Clarke (Baltimore)
  • HRM in patients before and after surgery R.P.  Tatum (Seattle)
  • HRM in rumination and aerophagia R. Tutuian (Bern)

Symposium 9 Tuesday, September 4, 7:45 - 9:30 am
Non specific motility disorders
The irritable esophagus

Chairs: R.W. McCallum (El Paso) – K. Vega (Oklahoma City)
Discussant: R.I. Rothstein (Lebanon)
Secretary: R. Hejazy (El Paso)

  • Is there a role for symptom- incomplete bolus clearance correlation in HRIM? (similarly to symptom-reflux correlation) A. Bansal (Kansas City)
  • Does eosinophilic esophagitis contribute to esophageal chest pain? S.R. Achem (Jacksonville)
  • What is the relationship between hypertensive LES and vigorous achalasia, a single entity? R.W. McCallum (El Paso)
  • How does Erythomycin affect esophageal motility? A. Lund-Krarup (Aalborg)
  • What is the current understanding of spasms localized to the lower esophagus? D. Sifrim (London)
  • Is presbyesophagus (aging esophagus) a meaningful term and what is its clinical impact D.O. Castell (Charleston)
  • Does Starlings Law apply to the esophagus? A. Lund-Krarup (Aalborg)
  • Is the irritable esophagus part of spectrum representing a diffuse disorder of alimentary motility? C.P. Gyawali (St Louis)                  
  • What is the impact of HRM on understanding an irritable esophagus? D. Sifrim (London)
  • Do ethnic and gender based norms impact on diagnosis and treatment of esophageal motor disorders? K. Vega (Oklahoma City)

Symposium 10 Tuesday, September 4, 9:40 – 11:25 am
Chest pain and motility disorders
Chairs: S.R. Achem (Jacksonville) – S.J. Sontag (Chicago)
Discussant: D.O. Castell (Charleston)

  • What are the specific neural structures that serve as mechano-receptive and thermo-receptive receptors involved in chest pain? M. Kollarik (Baltimore)                                 
  • What is the origin of chest pain: central, peripheral, or both? Q. Aziz (London)       
  • Health care and epidemiology of chest pain: a global problem? K. Vega (Oklahoma City)
  • Does barium esophagogram have a role in NCCP? C.L . Canon (Birmingham, AL)
  • Does normal pH exclude esophageal pain? M. Frazzoni (Modena)   
  • What is the role of High Resolution Manometry in NCCP? J. Clarke (Baltimore)    
  • What is the role of High resolution US in chest pain? R.K. Mittal (San Diego)
  • What is the meaning of esophageal motility disorders in chest pain? J.E. Richter (Tampa)
  • Should pH impedance be included in the evaluation of NCCP? M. Frazzoni (Modena)
  • Are there other treatment modalities for NCCP other than PPIs? S.R. Achem (Jacksonville)  
  • Non-traditional therapy for NCCP S.R. Achem (Jacksonville)      
  • What future research steps should be taken in NCCP? D.O. Castell (Charleston)