Thesis abstract:

«p»«span style="color:black"»The field of endoscopic tissue resection and third-space endoscopy has rapidly evolved over the past decade. While surgery is the traditional definitive therapy for many neoplastic, neurogenic and structural disorders of the gastrointestinal system, novel minimally-invasive endoscopic techniques have been developed. Techniques such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) have revolutionised the treatment of oesophageal, gastric and colorectal neoplasia, including early cancers. Per-oral endoscopic myotomy (POEM) is increasingly being used to treat oesophageal motility disorders, primarily achalasia, whilst submucosal-tunnelling endoscopic resection (STER) and endoscopic full-thickness resection (EFTR) can be used to excise subepithelial lesions. However, surgery remains highly utilised for all these conditions, likely due to an inherent established bias towards traditional surgical treatment paradigms. Furthermore, the aforementioned endoscopic interventions are relatively new, require expertise to perform and have a developing evidence-base. This research proposal aims to improve our understanding of these innovative techniques, to further define their utility and delineate selection within the framework of pre-existing guidelines. There will be a focus on endoscopic resection and third-space surgery for neoplasia (Barrett’s oesophagus, subepithelial lesions and colorectal polyps) and motility disorders (achalasia).«/span»«/p»