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It is used diagnostically, for staging, and therapeutically, shaping management across foregut diseases such as esophageal and gastric malignancies, achalasia, and gastroesophageal reflux disease. Evidence supports intraoperative UGI endoscopy as an adjunct for tumor localization, assessment of reconstruction, and identification of postoperative complication sources, though adoption is constrained by cost, access, and training requirements. This invited minireview summarizes indications, benefits, and related complications while sharing institutional experience.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/intraoperative-endoscopy-a-controversial-tool-or-a-necessity-in-modern-esophagogastric-surgery-minireviews/406751/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/intraoperative-endoscopy-a-controversial-tool-or-a-necessity-in-modern-esophagogastric-surgery-minireviews/406751.png","ImageObject",300,407,{"name":92,"@type":93},"Mary Man","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What roles does upper gastrointestinal endoscopy play in foregut disease management?","Question",{"text":112,"@type":113},"Upper gastrointestinal endoscopy supports diagnostic evaluation, disease staging, and therapeutic management across foregut conditions including esophageal and gastric malignancies, achalasia, and gastroesophageal reflux disease.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How can intraoperative upper gastrointestinal endoscopy help during esophagogastric surgery?",{"text":117,"@type":113},"It can enhance tumor localization, directly evaluate the surgical reconstruction, and identify potential sources of postoperative complications while improving staging accuracy and risk stratification.",{"name":119,"@type":110,"acceptedAnswer":120},"Why is intraoperative endoscopy not widely adopted despite emerging evidence?",{"text":121,"@type":113},"Its broader use is limited by concerns about cost, accessibility, and the need for sufficient training and expertise.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},406751,1791075327,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},7421720224475,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","| W | J | G | S | World Journal of\u003Cbr>Gastrointestinal Surgery |\n| --- | --- | --- | --- | --- |\n\nSubmit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Gastrointest Surg 2025 December 27; 17(12): 111262  \nDOI: 10.4240/wjgs.v17.i12.111262 ISSN 1948-9366 (online)  \nMINIREVIEWS  \nIntraoperative endoscopy: A controversial tool or a necessity in modern esophagogastric surgery?  \nDionysios Dellaportas, Ioannis Margaris, Charalampos M Charalampous, Zoi Gkiafi, Anastasia Pikouli, Despoina Myoteri, Nikolaos Pararas, Panagis M Lykoudis, Constantinos Nastos, Emmanuel Pikoulis  \nSpecialty type: Gastroenterology and hepatology  \nProvenance and peer review:  \nInvited article; Externally peer reviewed.  \nPeer-review model: Single blind  \nPeer-review report’s classification Scientific Quality: Grade C  \nNovelty: Grade C  \nCreativity or Innovation: Grade C  \nScientific Significance: Grade E  \nP-Reviewer: Birla R, PhD, Associate Professor, Romania  \nReceived: June 26, 2025  \nRevised: July 22, 2025  \nAccepted: October 11, 2025  \nPublished online: December 27, 2025  \nProcessing time: 181 Days and 15.5 Hours  \nDionysios Dellaportas, Anastasia Pikouli, Nikolaos Pararas, Constantinos Nastos, Emmanuel Pikoulis, 3rd Department of Surgery, University Hospital “Attikon”, School of Medicine, National and Kapodistrian University of Athens, Athens 12462, Attikí, Greece  \nIoannis Margaris, Charalampos M Charalampous, Zoi Gkiafi, Panagis M Lykoudis, 4th Department of Surgery, University Hospital “Attikon”, School of Medicine, National and Kapodistrian University of Athens, Athens 12462, Attikí, Greece  \nDespoina Myoteri, Department of Pathology, Aretaieion University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens 11528, Attikí, Greece  \nPanagis M Lykoudis, Division of Surgery and Interventional Science, University College London, London WC1E 6BT, United Kingdom  \nCorresponding author: Panagis M Lykoudis, MD, PhD, 4th Department of Surgery, University Hospital “Attikon”, School of Medicine, National and Kapodistrian University of Athens, 1 Rimini Street, Athens 12462, Attikí, [Greece.](Greece. p.lykoudis@ucl.ac.uk)[ p.lykoudis@ucl.ac.uk](Greece. p.lykoudis@ucl.ac.uk)  \nAbstract  \nUpper gastrointestinal (UGI) endoscopy has become increasingly popular with the recent advancements in technology and the increase of minimally invasive techniques. UGI endoscopy is indicated for diagnostic, staging, and therapeutic purposes and significantly influences the management of patients with a spectrum of foregut diseases, including esophageal and gastric malignancies, achalasia, and gastroesophageal reflux disease. There is growing evidence that intraoperative UGI endoscopy can be a useful adjunct and a powerful tool to enhance tumor localization, offering a direct evaluation of the surgical reconstruction and identifying potential sources of postoperative complications. However, its widespread utilization has been limited by concerns over cost, accessibility, and sufficient training and expertise. The aim of the current study was to review and elaborate on the available literature while presenting our experience in an academic institution specializing in esophagogastric surgery with intraoperative UGI endoscopy. We focused on the indications, added benefits, and related complications.  \nKey Words: Upper gastrointestinal surgery; Esophagogastroduodenoscopy; Foregut surgery; Esophagogastric surgery; Intraoperative endoscopy  \n WJGS  [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 27, 2025  Volume 17  Issue 12   \nDellaportas D et al. Intraoperative endoscopy in modern esophagogastric surgery  \n©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.  \nCore Tip: Endoscopy is indispensable for the evaluation of foregut conditions, supporting the formulation of a tailored plan for each surgical candidate. It provides live detailed visualization of tumor margins w","cbCaiv9PPLLvqD2n","https://ap.wps.com/l/cbCaiv9PPLLvqD2n","pdf",609109,"English","# Abstract\n# Core Tip\n# Introduction","[{\"question\":\"What roles does upper gastrointestinal endoscopy play in foregut disease management?\",\"answer\":\"Upper gastrointestinal endoscopy supports diagnostic evaluation, disease staging, and therapeutic management across foregut conditions including esophageal and gastric malignancies, achalasia, and gastroesophageal reflux disease.\"},{\"question\":\"How can intraoperative upper gastrointestinal endoscopy help during esophagogastric surgery?\",\"answer\":\"It can enhance tumor localization, directly evaluate the surgical reconstruction, and identify potential sources of postoperative complications while improving staging accuracy and risk stratification.\"},{\"question\":\"Why is intraoperative endoscopy not widely adopted despite emerging evidence?\",\"answer\":\"Its broader use is limited by concerns about cost, accessibility, and the need for sufficient training and expertise.\"}]","Intraoperative endoscopy: A controversial tool or a necessity in modern esophagogastric surgery - Minireviews | PDF",1790567688,25]