History of the Department of Endoscopy

The endoscopy service was first established at the Center in 1968 and was then a part of the Department for Outpatient Diagnostics and Treatment of Tumors. The inception of the endoscopy service at the Center is associated with K.A. Pavlov, who was the head of the Department for Outpatient Diagnostics and Treatment of Tumors, Yu.F. Stefanenko, D.P. Volkov, V.G. Chernomordikov and A.M. Shcherbakov. In the 1970s-1980s, the service’s efforts were mainly concentrated on the study of a possible use of endoscopy for outpatients. The results of this study were summed up in several PhD qualification papers: ‘Role of fibrogastroscopy in the comprehensive diagnosis of stomach cancer in an outpatient setting’ by Yu.F. Stefanenko (1975), ‘Fibrogastroscopy in the diagnosis of neoplasms (recurrent and primary cancer) of the gastric remnant’ by D.P. Volkov (1978), and ‘Role of endoscopy in the comprehensive diagnosis of stomach polyps in outpatients’ by V.G. Chernomordikov (1985). Endoscopic treatment procedures, such as endoscopic polypectomy, were rapidly evolving and in 1983 A.M. Shcherbakov wrote a PhD dissertation entitled ‘Electrosurgical polypectomy during fibrocolonoscopy in the outpatient and inpatient setting’.

An ever-growing demand of the outpatient clinic and the Center in endoscopic procedures made it necessary to create a separate dedicated endoscopy unit at the Center, which was realized in 1992 when an endoscopy room was opened at the outpatient clinic. On July 1, 1993 K.P. Khanson, Director of the Center, signed an official order to establish the Department of Endoscopy as a separate division of the Center.

Professor A.M. Shcherbakov was appointed Head of the Department at the time of its establishment; at present Professor Shcherbakov, D.Sc., is Deputy Director of the Center and the head of research of the Department of Endoscopy.

Apart from its daily clinical activities aimed at endoscopic examination of inpatients and outpatients, the Department pursued research in the field of development of new endoscopy procedures to diagnose benign and malignant tumors, and to assess the efficacy of such procedures. Such new endoscopic technologies like argon plasma coagulation and laser coagulation, and photodynamic therapy, which were invented in the early 2000s, allowed the Department to start performing a large number of endoscopic treatment procedures. The main focus in this area was the development of the methods of combined esophageal and stomach recanalization, esophagogastric and esophagointestinal anastomosis, and tracheal and bronchial anastomosis for obstructing malignant tumors. As a result, the Department has successfully developed a unique endoscopic surgery technique that uses the method of argon plasma coagulation by itself or in combination with high frequency electrosurgery, which ensures a complete or partial reopening of the lumen of an organ in 90% of all case. To treat inoperable patients with esophageal cancer, the Department started using a treatment modality that involved the successive use of endoscopic intraluminal surgery with combined radiotherapy (intraluminal high-dose brachytherapy + external-beam radiotherapy), which allowed to achieve a significant local effect in 80% of all cases. The research in this field culminated in a PhD thesis by A.A. Avanesyan entitled ‘Possible uses of argon plasma coagulation in flexible endoscopy to treat neoplasms of the gastrointestinal tract and the tracheobronchial system’ (2006) and a D.Sc. thesis by A.M. Shcherbakov entitled ‘Clinical significance of endoscopic intraluminal surgery in the treatment of inoperable patients with esophageal cancer’ (2006).

In cooperation with the Thoracic Surgery Department, the Department has developed the combined techniques for performing endotracheobroncial surgeries during rigid bronchoscopy for locally advanced and metastatic non-small cells lung cancer, involving the blocking of the central bronchi and trachea. These techniques allow a full (in 30% of cases) or partial (in 70% of cases) reopening of the airways with complete or partial treatment of respiratory failure and considerable improvement of patients’ lives. The results of the efforts in this area were summed up in a D.Sc. thesis by A.I. Arseniev entitled ‘Improvement of methods for treating locally advanced non-small cells lung cancer’.

The results of the study of the clinical significance of automated quantitative cytometry and fluorescence bronchoscopy combined with spectroscopy to diagnose lung cancer were summed up in a PhD thesis by A.A. Barchuk in 2010. The thesis proved a possibility in principle to efficiently use multiple-component systems for early detection of lung cancer.

An ever-larger number of indications for gastrointestinal endoscopy and a growing number of patents with comorbidities and elderly patients have made the issue of anesthesia for endoscopic procedures relevant. The results of the research in this area were summed up a PhD thesis by O.Ya. Zamiralova entitled ‘Anesthesia for gastrointestinal endoscopy for cancer patients’ (2002).

In 2012, the Department was headed by Oleg B. Tkachenko, who is an endoscopist with the first qualification category, a member of the Russian Society of Endoscopy and the European Society of Gastrointestinal Endoscopy, and a surgeon with more than 10 years of experience of working in leading clinics of Saint Petersburg. Dr Tkachenko received extensive training in clinical centers in Japan, the USA and Europe. His appointment boosted the development of surgical endoscopy, and namely endoscopy treatment of early cancers of the esophagus, stomach, and colon, and endoscopy removal of submucosal masses of the gastrointestinal tract. A growing number of surgical treatments necessitated the development of the methods and techniques for diagnostic procedures, and the introduction into clinical practice additional detail-enhancing medical procedures, such as chromoendoscopy and narrow-band imaging. Early cancer detection is accompanied by a need for more precise staging of cancers to select the best treatment plan. For endoscopic removal of submucosal masses at the pre-surgery stage, it is necessary to establish the nature of the mass, its real sizes and its location as regards the wall of an organ. The specialists of the Department have mastered the difficult procedure of endoscopic ultrasound, thus making it possible to resolve the above issues.

Throughout its history, 3 D.Sc. and 9 PhD dissertations were defended at the Department. The specialists of the Department published more than 300 publications – monographs, polygraphs, book chapters, guides, articles, and conference abstracts. The Department has more than 14 patents for an invention.