Category: Upper Gastrointestinal Tract

High Postoperative IL-6 Levels Deteriorate Outcomes in Esophageal Cancer

Elevated serum interleukin-6 (IL-6) levels one day post-minimally invasive esophagectomy (MIE) correlate with significantly poorer overall survival rates and nutritional status in esophageal cancer patients. In a cohort of 336 patients, those with IL-6 levels ≥60 pg/ml exhibited a 2-year overall survival rate of 69.8%, compared to 80.6% for those with lower levels. The study […]

Combination of omega-3 PUDAs and alanyl-glutamine enhances recovery

Alanyl-glutamine and omega-3 polyunsaturated fatty acids positively influenced postoperative outcomes in patients with gastroduodenal perforations. In a study involving 168 patients, those receiving the combination therapy experienced significant increases in total protein and albumin levels, alongside reduced C-reactive protein levels, indicating lower inflammation. Notably, group C (receiving both treatments) had the shortest hospitalization time and […]

Chewing gum significantly reduces postoperative ileus duration

A multicentre randomized controlled trial involving 52 patients revealed that chewing gum can significantly shorten postoperative ileus following laparotomy for gastroduodenal perforations. The median duration of ileus was reduced by 21.5 hours in patients who chewed gum compared to those who did not (28.5 hours vs. 50 hours, p=0.002). Additionally, the length of hospital stay […]

Improved Detection of Metastases in Esophageal Cancer

A review highlights that sentinel lymph node mapping significantly enhances metastasis detection in esophageal cancer. This technique targets lymph nodes likely to harbor metastases using various tracers, aiding surgical lymphadenectomy, increasing accuracy, and personalizing treatment. While the need for larger studies and long-term data remains, preliminary findings indicate improved staging without a notable rise in […]

Machine learning predicts duodenal stump leakage in gastric cancer.

A machine learning model was developed to predict duodenal stump leakage (DSL) in 1,107 gastric cancer patients post-gastrectomy. The model utilized 189 clinical features and evaluated six algorithms, with extreme gradient boosting (XGB) achieving the highest area under the receiver operating characteristic curve (AUROC) score of 0.880. Random forest followed with a score of 0.858. […]

Four distinct trajectories of postoperative recovery identified.

The study identified four postoperative quality of recovery (QoR) trajectories among 206 esophagectomy patients: poor QoR (18.4%), poor to moderate QoR (40.3%), moderate to good QoR (24.8%), and good QoR (16.5%). Key predictors of poor QoR included preoperative nutritional risk, lower QoR-15 scores, longer surgical duration, and higher postoperative pain scores during coughing. These findings […]

High postoperative complications and mortality remain in gastric volvulus surgeries.

A systematic review analyzed surgical outcomes for acute gastric volvulus due to large paraesophageal hernias, involving 15,178 patients across 171 studies. Despite advancements, 32% faced postoperative complications, 7.6% required reinterventions, and 30-day mortality reached 5.7%. The average hospital stay was 7.9 days. These concerning results underscore the need for early diagnosis and timely surgical intervention […]

Sequential injection-electrocoagulation improves hemostasis in ESD.

A randomized controlled trial involving 69 patients demonstrated that the sequential injection-electrocoagulation method significantly reduced the median time to hemostasis during endoscopic submucosal dissection (17 seconds) compared to traditional electrocoagulation (22 seconds), with p < 0.001. The experimental method also yielded higher visibility scores (3.24 vs. 2.82; p < 0.001) and reduced muscle injuries compared […]

Vagus nerve-preserving gastrectomy improves outcomes in early gastric cancer

A multicenter analysis involving 1,210 early gastric cancer patients revealed that vagus nerve-preserving gastrectomy enhances perioperative safety and postoperative quality of life. Patients experienced shorter hospital stays and fewer complications such as diarrhea and acid reflux. A validated 6-point risk assessment model, derived from key factors like tumor size and invasion depth, effectively categorized patients […]

Minimally invasive oesophagectomy reduces surgical complications

A nationwide study in Finland reveals that minimally invasive oesophagectomy (MIO) significantly lowers rates of surgical complications compared to open oesophagectomy (OO). Key findings include reductions in anastomotic leakage (10% vs. 14%), major complications (35% vs. 47%), and reoperations (18% vs. 26%). While rates of pneumonia and intra-abdominal abscesses were also lower with MIO, these […]