A systematic review and meta-analysis of six randomized clinical trials involving 850 patients highlights the benefits of enhanced recovery after surgery (ERAS) protocols following oesophagectomy. The analysis showed significantly reduced overall complication rates, pulmonary complications, and shorter post-operative length of stay and time to flatus in the ERAS group compared to standard care. However, no […]
Category: Upper Gastrointestinal Tract
Effective management strategies for recurrent laryngeal nerve palsy identified
Recurrent laryngeal nerve palsy remains a major complication after minimally invasive esophagectomy for esophageal cancer. Despite advancements, incidence rates have not improved significantly. The review examines prevention strategies such as nerve integrity monitoring and robotic surgery, which show varied effectiveness. Management techniques include voice rehabilitation and surgical options like thyroplasty. A multidisciplinary approach focused on […]
Modified suturing technique achieves high closure rate in duodenal ESD
A modified double-layered suturing method, known as the origami method, demonstrated a 96% success rate in achieving complete closure of large mucosal defects following duodenal endoscopic submucosal dissection (ESD). In a review of 28 cases, closure was completed with a median time of 16 minutes, and no complications such as perforations or bleeding were observed. […]
Key predictors identified for successful outcomes in gastroparesis treatment
A systematic review of 1,899 articles identified 30 relevant studies on gastric peroral endoscopic myotomy (GPOEM) for refractory gastroparesis. Findings revealed a GPOEM response rate of 63.1%. Key predictors for a positive response included older age, shorter gastroparesis duration, nondiabetic etiology, lower body mass index, and previous improvement with intrapyloric botulinum toxin. However, variability in […]
Favorable long-term outcomes observed in gastric neuroendocrine tumors
A study analyzing 69 patients with gastric neuroendocrine tumors (GNETs) showed a favorable prognosis, with 5-year survival rates at 93.8% and recurrence rates at 7.25%. Most tumors were grade 1 and type I, with treatment variations between tumor grades; grade 1 patients often opted for endoscopic treatment, while grade 2 received surgical or chemotherapeutic interventions. […]
Machine learning effectively predicts early recurrence in gastric cancer.
A multicenter study identified early recurrence (ER) within two years post-surgery in 15% of 11,615 gastric cancer patients. Utilizing machine learning, researchers developed a stacking ensemble model that achieved an area under the receiver operating characteristic curve of 1.0 for training and 0.8 for testing, indicating robust predictive capability. Key predictors included tumor size, staging, […]
Gastrectomy at university hospitals reduces mortality in gastric cancer.
A nationwide study in Finland found that patients undergoing gastrectomy at university hospitals experience lower short-term and long-term mortality rates compared to those treated at nonuniversity hospitals. An analysis of 10,455 patients from 1987 to 2016 indicated that university hospital patients were younger and had more comorbidities. Notably, survival rates at university hospitals were higher […]
Multimodal prehabilitation enhances recovery in frail gastric cancer patients
Multimodal prehabilitation significantly improved physical capacity and reduced chronic inflammation in frail elderly patients undergoing gastric cancer surgery. The intervention, encompassing physical training, nutritional support, and psychosocial treatment over two weeks, resulted in a mean 6-min walk test change of +28 meters (p < 0.001). Notably, inflammation-related indicators improved, and proinflammatory cytokine release decreased, with […]
Machine learning predicts duodenal stump leakage risk in gastric cancer
A new predictive model utilizing machine learning has shown promise in forecasting duodenal stump leakage after laparoscopic gastrectomy for gastric cancer. Analyzing data from 4,070 patients, the support vector machine emerged as the most effective algorithm, achieving high sensitivity, accuracy, and specificity. Key factors influencing leakage risk include tumor location, tumor stage, operation time, preoperative […]
Fatigue and Alopecia Are Key Challenges in Esophageal Cancer Treatment
In a study of 75 esophageal squamous cell carcinoma patients undergoing neoadjuvant immunochemotherapy, treatment-related adverse events (TRAEs) were better characterized over time using latent-class mixed-modeling. Most TRAEs, including pruritus, nausea, vomiting, and pain, improved, while fatigue and alopecia worsened. Patients with severe gastrointestinal TRAE trajectories had significantly poorer overall survival compared to those with mild […]