Staging laparoscopy reveals peritoneal disease in over half of advanced gastric cancer patients, enhancing surgical decision-making. Peritoneal disease was found in 54.9% of patients undergoing staging laparoscopy, with positivity rates of 61.7% in type 4 lesions. The sensitivity and specificity of staging laparoscopy were 94.6% and 100%, respectively, demonstrating high diagnostic accuracy. The four-factor predictive […]
Category: Upper Gastrointestinal Tract
New risk scoring for achalasia post-POEM reveals critical patterns.
The JAMS POEM score effectively predicts short-term clinical failure (AUROC 0.71) but loses accuracy long-term (AUROC 0.54). A three-tiered risk stratification identifies an intermediate-risk group with a 10-year failure rate of 35.8%, suggesting different follow-up strategies. Surgeons should consider long-term outcomes when applying the JAMS POEM score for better patient surveillance. In the low-risk group, […]
Effective outcomes for laparoscopic hiatal hernia repair with cTIF
Laparoscopic hiatal hernia repair combined with consecutive transoral incisionless fundoplication (cTIF) achieves high success rates in GERD patients. 92% of patients achieved complete clinical success within 12 months. Symptom improvement was reported by 90% and 84% normalized esophageal acid exposure. Most patients (84%) stopped daily proton pump inhibitors, enhancing long-term management potential for surgeons. Serious […]
Neoadjuvant Serplulimab Improves Survival in PD-L1-Positive Gastric Cancer
Neoadjuvant serplulimab with chemotherapy enhances event-free survival in PD-L1-positive gastric cancer, making it a promising strategy for surgeons. Median event-free survival was longer with serplulimab (not reached) compared to placebo (42 months) for patients with PD-L1 CPS ≥10 (HR 0.65, p=0.0082). In the overall patient population, event-free survival was also improved (not reached vs. 35.9 […]
Laparoscopic Exploration Crucial for Assessing Occult Metastasis in Gastric Cancer
Laparoscopic exploration is vital for detecting occult peritoneal metastasis (opm) in gastric cancer, significantly impacting patient outcomes. 22.2% of 653 patients showed opm+ initially, linked to worse survival (15.9 months vs not reached). Younger age, better ECOG status, primary gastric cancers, and specific CA72-4 levels were risk factors for opm+. Re-evaluating opm status post-treatment revealed […]
Novel Uniportal Robotic Approach for Esophagectomy Shows Promise
Uniportal robotic-assisted minimally invasive esophagectomy is a safe option for esophageal cancer patients, showing strong early outcomes. Complete resection achieved in 95% of cases, with low conversion rate (5%). Median operative time was 155 minutes with an average blood loss of 450 ml. Consider this technique for suitable patients, as it supports quicker recovery and […]
Quantitative Imaging Cuts Esophageal Surgery Leakage Risk
Intraoperative quantitative blood flow measurement significantly reduces anastomotic leakage in esophageal cancer surgery. Patients using SPY-QP imaging had lower overall complication rates and less postoperative leakage. They experienced a shorter hospital stay and less intraoperative blood loss. Quantitative assessment helps optimize anastomotic site selection, improving patient outcomes. The quantitative group had more preoperative chemotherapy and […]
Pathological insights after neoadjuvant treatment for esophageal cancer
One-third of patients with locally advanced esophageal cancer show a complete clinical response to neoadjuvant chemoradiotherapy, but managing uncertain responses is critical for surgical success. Only 15% of patients with uncertain tumor response achieved a complete pathological response after esophagectomy. Complete response rates varied: 26% for non-traversable lesions, 10% for high-grade dysplasia, and 8% for […]
Toupet vs. fundopexy: fewer reoperations with fundopexy
Fundoplication options show noteworthy differences in recurrence rates and patient outcomes. Fewer symptomatic recurrences after fundopexy: 1.3% vs. 17.3% for toupet over 66 months. Comparable rates of postoperative dilation for dysphagia: 21.3% for toupet, 13.3% for fundopexy. Consider fundopexy for patients at risk of recurrence; randomized studies are needed to confirm these findings. Similar complication […]
POEM and LHD show similar long-term outcomes for achalasia.
At 5 years, 87.3% of POEM and 90.1% of LHD patients had an Eckardt score ≤3. POEM patients had a higher need for PPIs (45.6% vs 24.6%) and increased rates of esophagitis (34% vs 10.4%). Surgeons should consider the higher GERD incidence with POEM when selecting treatment. Symptomatic recurrence at 5 years was low in […]