Brachytherapy of esophagus cancer in Hospital Cologne-Holweide

About the department

The Department of Gastroenterology at the Hospital Cologne-Holweide provides the full range of diagnostic and therapeutic services in accordance with the requirements of modern European medicine. The medical facility specializes in the diagnostics and treatment of gastrointestinal diseases, such as stomach, small intestine, large intestine, esophageal, and pancreatic conditions. The department's team of gastroenterologists focuses on patients with malignant diseases of the digestive system that are treated in cooperation with general and abdominal surgeons. The department's physicians have vast experience in providing medical care to patients with inflammatory bowel diseases such as Crohn's disease and ulcerative colitis. Patients with infectious gastrointestinal diseases are also treated here. When treating patients, the department's gastroenterologists actively use drug therapy and endoscopic procedures. The department has the largest Endoscopy Center in North Rhine-Westphalia, where more than 12,000 procedures are performed annually. Clinical practice strictly adheres to current clinical protocols, and the medical staff ensures compliance with hygiene and safety standards. The physicians make every effort to provide high-quality treatment, devote sufficient time to personal communication with patients, and take into account their individual needs and wishes. The department is headed by Prof. Dr. med. Arno Dormann.

A team of gastroenterologists, in cooperation with abdominal surgeons, treats patients with gastrointestinal cancer. Doctors often deal with the treatment of stomach cancer, in which a malignant tumor is formed from the mucous membrane cells of the organ. The specialists have in their arsenal many effective endoscopic techniques for the removal of stomach tumors, such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). Patients need to understand that sparing endoscopic treatment ensures good results only when cancer is detected in the early stages. In the advanced stages of stomach cancer, abdominal surgeons are engaged in the therapeutic process. Their task is the removal of the malignant stomach tumor or resection of the organ. The endoscopic procedure or surgery is often complemented by chemotherapy and/or radiation therapy.

The department also successfully performs endoscopic procedures for colon and esophageal cancer. In the early stages of colon cancer, it is possible to remove the malignancy during colonoscopy, while esophageal cancer can be removed using endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). The patient's diagnostic results are assessed by gastroenterologists and abdominal surgeons, who cooperatively decide on the most effective treatment. As a rule, when dealing with advanced stages of cancer, surgeons have to perform extensive resections.

Another priority focus of the department's doctors is the treatment of gastroesophageal reflux disease (GERD). This is a chronic pathology that occurs due to esophageal sphincter dysfunction, as a result of which the stomach contents move up into the esophagus and irritate its walls. In most cases, the diagnosis of suspected GERD is not complex. During the diagnostic process, a patient may undergo narrow-band imaging, intragastric pH-metry, impedance-pH monitoring, contrast-enhanced swallowing assessment, chest CT, and gastric emptying scintigraphy. As for the treatment, conservative options are considered first. These include lifestyle modification (smoking cessation, weight loss, and a healthy diet) in combination with drug therapy (most often proton pump inhibitors are prescribed). In complicated cases, surgical treatment may be performed, such as fundoplication or the implantation of the innovative LINX Reflux Management System device. Operations are performed using laparoscopic techniques.

Gastroenterologists also have excellent professional qualifications in the treatment of inflammatory bowel diseases such as Crohn's disease and ulcerative colitis. A diagnostic protocol for suspected above-mentioned pathologies includes gastroscopy, endoscopy, magnetic resonance imaging, video capsule endoscopy, classical endoscopy, laboratory tests, and other examinations. A treatment regimen is developed based on the diagnostic results, which usually includes drug therapy with the use of various groups of drugs and diet therapy aimed at eliminating nutrient deficiencies. Crohn's disease and ulcerative colitis are associated with a high risk of bowel obstruction and bowel cancer, whose treatment mostly requires surgery.

The department's range of diagnostic and therapeutic services includes:

• Endoscopy
  • Gastroscopy
  • Colonoscopy
  • Esophagogastroduodenoscopy
  • Magnifying endoscopy and narrow-band imaging endoscopy
  • Chromoendoscopy
  • Endosonography
  • Esophageal manometry
  • Esophageal pH-metry
• Endoscopic therapeutic procedures
  • Polypectomy
  • Balloon dilatation and botulinum toxin injections for achalasia cardia
  • Endoscopic mucosal resection (EMR) and argon plasma coagulation for gastrointestinal tumors at the early stages
  • Balloon dilatation and stent implantation for stomach and esophageal stenosis
  • Latex ligation and endoscopic obliteration for esophageal varices with special adhesives
  • Clipping, injections, and argon plasma coagulation for gastrointestinal bleeding
  • Argon plasma coagulation for angiodysplasia
  • Endoscopic removal of foreign bodies from the gastrointestinal tract
  • Percutaneous endoscopic gastrostomy
  • Percutaneous endoscopic jejunostomy
• Other diagnostic and treatment methods