ISDE News

Written by Christophe Faure on behalf of the INoEA Pediatric Gastroenterology, Sainte-Justine UHC Professor of Pediatrics, Université de Montréal, Montréal, QC, Canada

Pediatric and adult patients born with esophageal atresia with or without tracheoesophageal fistula (EA/TEF) are at risk for respiratory infections and severe complications. This is mostly related to the association of the esophageal condition with tracheomalacia, asthma or gastroesophageal reflux. Taking advantage of the International Network of Esophageal Atresia (INoEA) we aimed to investigate the impact of the SARS-CoV-2 in patients previously operated of esophageal atresia.

An international survey was conducted amongst the INoEA members starting on April 2020 and still recruiting (for information www.inoea.org). Information on demography, type of esophageal atresia, co-morbidities, clinical data regarding EA-TEF, symptoms suggestive of the SARS-CoV-2 infection, complications, hospitalization, and therapies administered for COVID-19 was collected for all patients who were reported. The study was approved by the Sainte-Justine University Health Centre IRB.

Seventeen patients (14 children, 9 males) with a mean age of 69.4 months (range 12 months – 30 years) were reported from Italy, Argentina, Switzerland, Netherland, Canada, France, India and Turkey. All patients had a documented infection confirmed by PCR or rapid test except 3 children who were considered positive after a contact with an infected person.

Nine patients (53%) had a type C EA-TEF, 4 (23%) a type A, 3 an other type. Eleven (65%) had chronic respiratory problems (asthma n=3, tracheomalacia n=5, recurrent respiratory tract infections n=3). Six (35%) had associated cardiac malformations. Seven (41%) had an history of recurrent anastomotic strictures. PPI (n=4, 23%), swallowed budesonide (n=3, 18%), inhaled bronchodilatators or corticosteroids (n=5, 29%) were the most frequent reported medications. Symptoms at presentation included cough (n=5, 29%), fever (n=2, 12%), vomiting (n=2, 12%), rhinitis (n=1, 6%) and abnormal taste or anosmia (n=2, 12%).

Six patients (35%, 4 children and 2 adults) were hospitalized. None needed any respiratory support except one who was temporarily put on nasal oxygen. No specific treatment directed to SARS-CoV-2 was administered. No patient was admitted in ICU. All six patients were discharged with an uneventful outcome. The remaining 11 patients had similarly an uneventful outcome.

In conclusion, in patients with EA/TEF, the SARS-CoV-2 infection does not represent a risk for severe respiratory complications or severe outcome. The high rate of hospitalization is probably due to a selection bias of the present survey and may be linked to a highest awareness of the health providers towards the population of EA/TEF patients.

Written by Prof. Mark Ferguson, University of Chicago, USA

The 1st and 2nd ISDE World Congresses were an outgrowth of parallel efforts in Japan and in the West to develop international collaboration among physicians and surgeons treating esophageal diseases. During the 2nd Congress in Rome, Professor Rudiger Siewert proposed that a joint congress be held by the two groups in 1986 as a first step in creating a merger between them.

Thus, the 3rd ISDE World Congress was hosted in 1986 by Professor Siewert (Congress President) in Munich at the Technical University, with able support from Professor Arnulf Holscher (Figure 1). Professor Kyoshi Inokuchi was named ISDE President, and Professor Nakayama was named Honorary ISDE President (Figure 2). The Congress overlapped with the famous Oktoberfest event in Munich, and the juxtaposition was celebrated in part by having large steins of beer served starting as early as the 10:00 AM break between sessions. The scientific discourse was lively, and few will forget the social events, which were livelier still (Figure 3)! Over 600 abstracts were submitted for the meeting, and registration expanded considerably. The Congress was joined by other esophageal organizations centered in Europe, including Group European Etude Maladies Oesophage (GEEMO) and the International Organization for Statistical Studies of Esophageal Disease (OESO), the latter founded by Professors Lortat-Jacob and Robert Giuli. Professor Lortat-Jacob was named the first Honorary Member of the ISDE. The Congress proceedings were published as Diseases of the Esophagus: Pathophysiology, Diagnosis, Conservative and Surgical Treatment, published by Springer-Verlag and edited by Professors Siewert and Holsher.

Using the model established by the 1986 Congress, the 4th ISDE Congress was held in Chicago in 1989, hosted by Professors David Skinner, Alex Little, and Mark Ferguson. The Congress venue was the newly opened Fairmont Hotel (Figure 5). The Congress President was Professor Skinner (Figure 4), and Professor Inokuchi was ISDE President. Three Honorary Memberships were awarded to Professors Ronald Belsey (Bristol, England), Guam Bee Ong (Hong Kong), and Spencer Payne (Rochester, MN). Nearly 600 abstracts and films were submitted on benign and malignant disease, and 336 were selected for presentation across four different venues. The social program was highlighted by a performance by the Queen of the Blues, Koko Taylor (Figure 6). The proceedings of the Congress were published in two volumes by Futura as Diseases of the Esophagus, Volume I: Malignant Diseases, and Diseases of the Esophagus, Volume II: Benign Diseases (Figure 7), edited by Professors Skinner, Little, and Ferguson.

Figure 1. Registration activities at the 3^rd ISDE Congress held in Munich.

Figure 2. Professors Siewert and Nakayama confer at an ISDE committee meeting during the 3rd ISDE Congress.

Figure 3. The social events during the 3rd ISDE Congress often included folk dancing and traditional local musical entertainment.

Figure 4. David B. Skinner, MD, 4th ISDE Congress President.

Figure 5. Fairmont Hotel, Chicago, site of the 4th ISDE Congress.

Figure 6. Koko Taylor, Queen of the Blues.

Figure 7. Diseases of the Esophagus volumes.

Dear Colleagues,

After careful consideration, we have made the very difficult decision to switch the ISDE 2021 World Congress to a virtual format. Although we were very much looking forward to welcoming you to Toronto, asking you all to travel to Canada and attend in person this August was just too risky. Even with the start of the delivery of vaccines, the confidence to travel safely abroad continues to have uncertainty, and we felt this to be the most responsible path for ISDE and all its stakeholders. The health and safety of the entire ISDE community is of the utmost importance and is what drove our decision at this time.

We are now very excited to announce the virtual ISDE 2021 congress, which will take place between September 27 and 30, 2021.

We have been working hard to build an engaging virtual program. We will also open abstract submissions so that the community has ample opportunity to submit their latest scientific research. We introduced an additional submission topic related to Covid-19 and its impact on your practice.

While we will not get to meet in person this year, we look forward to providing a virtual experience that is accessible worldwide and to enable attendees to connect and access the latest research through a new format. Since we know how busy you all are, 4 hours of scientific content per day will be scheduled across 4 days, with the live stream timing varying each day to allow for different regional time zone across the world. If the timing for a specific session doesn’t work for you, then it will be very accessible to stream later at your convenience.

We thank you once again for your continued interest in ISDE, and we hope you will join us virtually this September!

Sincerely,

Professor David Watson

ISDE President

March 23, 2021 12:00-13:30 GMT

Join us for a case-based discussion on multidisciplinary management of esophageal neoplasm covering such topics as esophageal cancer surgery, oncological treatment, management of complications of surgery, and endoscopic treatment. Registration is free!

DOTE Volume 34, Issue 1 | Featured Article

Members Only Article

Standardization is of key importance when comparing different results, specially in surgery. In this context, a barrier existed up to recently due to the lack of a consistent lexicon to define complications, with specific complications often not defined at all, or variable terms utilized. To enable research in this area, and comparison with published studies, and national and international comparative audit and benchmarking, the Esophageal Complications Consensus Group (ECCG) was established in 2011.The Esodata (Esodata.org) collaboration evolved from such an initiative, creating an enormously powerful dataset of contemporary international practice and outcomes. Reynolds, JV et al., compare the outcomes and complications of esophageal resections after centralization of esophageal cancer treatment in Ireland. The patients undergoing esophageal resection at St. James’s Hospital, Dublin, the designated Irish National Esophageal and Gastric Center (INC) between January 2014 and December 2018, were prospectively studied. Their data was compared to the original study published by the ECCG consortium and with the Dutch Upper Gastrointestinal Cancer Audit (DUCA).

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DOTE Volume 34, Issue 1 | Editor's Choice

Free Article

Anastomotic leakage is one of the most severe complications after esophagectomy and is associated with increased postoperative morbidity and mortality. Several projects ranging from small retrospective studies to large collaborations have aimed to identify potential pre- and perioperative risk factors and to improve the diagnostic processes and management. Despite the increase in available literature, many aspects of anastomotic leakage are still debated, without the existence of widely accepted guidelines. Read the full Anastomotic leakage after esophagectomy article for free.

DOTE Volume 34, Issue 1 | Editor's Choice

Free Article

As the awareness among gastroenterologists regarding endoscopic features suggesting eosinophilic esophagitis is increasing, individuals without symptoms of esophageal dysfunction are increasingly being found to have esophageal eosinophilia on biopsies performed during upper gastrointestinal endoscopies. However, the course of disease and the management of these asymptomatic individuals with esophageal eosinophilia remain elusive. Read the full how to approach adult patients with asymptomatic article for free.

Checkout the latest DOTE issue for articles on Benign Esophageal and Malignant Esophageal Diseases; See the full table of contents.

Review a collection of the top ten articles from recent years in a reading list.

Written by Prof. Mark Ferguson, University of Chicago, USA

As many know, the origins of the ISDE began synchronously in Japan and in the West, the latter primarily in Europe and the United States. It was founded by Professor Komei Nakayama (Figure 1) in 1979 with three objectives: to establish an international forum; to promote research performed with uniform standards on a worldwide scale; and to promote international friendship and communication. The first congress was held in Tokyo in 1980, with Professor Nakayama serving as ISDE President and as Congress President (Figure 2). The meeting was well attended by experts from both the East and West, as Professor Nakayama had an international reputation and had traveled extensively, enabling him to become friends with other international leaders in esophageal diseases (Figure 3). Guests included Professors Alberto Peracchia, Rudiger Siewert, Guido Castrini, Robert Giuli, and Ernesto Moreno Gonzalez. This first ISDE congress included topics on management of esophageal cancer, surgical complications, motility disorders, varices, and hiatal hernia/GERD, and also had movie sessions. It met all of the goals established by Professor Nakayama.

The second ISDE World Congress was held in Rome in 1983 (Figure 4), with Professor Guido Castrini of Rome (Figure 5) serving as Congress President and Professor Nakayama remaining as ISDE President (Figure 6). This was envisioned as a more multi-specialty meeting focusing on both malignant and benign esophageal diseases. During the congress Professor Siewert proposed that the Japanese and Western societies join together as one, with emphasis on expanding the concept of the original ISDE to include both gastroenterologists and surgeons. He suggested that the first step in this process should be a joint meeting in 1986 that he offered to host in Munich. It was also proposed by Professor Castrini that the ISDE found a journal, Diseases of the Esophagus, which would be the publication arm of the Society. This eventually was launched in 1988. The congress was well attended, and gave the encouraging message that the ISDE was a sound concept that had a promising future.

In our next installment, summaries of the third and fourth congresses will highlight how the ISDE matured and the pattern for its congresses was established. 

Figure 1. Professor Komei Nakayama, ISDE Founder.

Figure 2. Program from 1st ISDE Congress.

Figure 3. Opening ceremony from 1st ISDE Congress. 

Figure 4. Announcement of 2nd ISDE Congress. 

Figure 5. Professor Guido Castrini. 

Figure 6. Mr. Ronald Belsey and Professor Nakayama compare notes prior to beginning a session at the 2^nd ISDE Congress.

Written By: Prof. Long-Qi Chen, West China Hospital, Sichuan University, China

On November 21, 2020, the “Chinese Society for Diseases of the Esophagus (CSDE) Working Conference” was successfully held in Shenzhen, China. It brings together multiple specialties focused on the clinical management and research of patients with esophageal diseases. Given that the fight against COVID-19 is still at a critical stage worldwide, more than half of the delegates chose to attend the conference online. Since its inception, CSDE has been playing as an excellent platform for the academic exchange of clinical and scientific knowledge on the latest developments. At the conference, Prof. Luhua Wang, Dean of the Shenzhen Branch of the Cancer Hospital of the Chinese Academy of Medical Sciences, was elected as the President of CSDE. Prof. Yin Li, from the Cancer Hospital of the Chinese Academy of Medical Sciences, was elected as President-Elect. Prof. Yousheng Mao, the Past President of CSDE, made a summary report on the work of CSDE during his presidency. He emphasized that with the exchanges with ISDE in recent years, more and more Chinese specialists have gone abroad and stepped onto the international stage, demonstrating Chinese research results in esophageal industry.

Prof. Yousheng Mao

After that, Prof. Luhua Wang, the newly-elected president, delivered a speech. He expressed the thanks to every member for their trust. He believed that CSDE would play a bigger role in Chinese esophageal industry under the support of ISDE, and more creative and influential academic activities would be held in the year of 2021.

Prof. Luhua Wang

In the end, Prof. Longqi Chen, Director of the Executive Committee of ISDE, Director of the Department of Thoracic Surgery of West China Hospital, Sichuan University, Executive Director of CSDE delivered a speech. He congratulated the newly elected President and ministers. He mentioned that it was great that more and more esophageal experts in China have joined CSDE, and the influence of CSDE in the world is increasing. By working together with specialists both home and abroad, CSDE will serve the esophageal community better and benefit more patients.

Prof. Long-Qi Chen

Through this annual work conference, the past work of CSDE was profoundly summarized, and future plans were comprehensively deployed. We will always bear in mind and practice the mission:

To promote the exchange of scientific and medical knowledge of the esophagus among specialists in the field.

To maintain interchange with organizations and industries interested in esophageal and related diseases.

To encourage basic and clinical research in fields related to the esophagus.

To promote the professional and educational development of individuals interested in the esophagus and related diseases and to encourage, represent, and sponsor individuals who have entered this field.