Intraoperative adverse events (IAEs) during robot-assisted minimally invasive esophagectomy (RAMIE) can occur in about 8.6% of cases, but most are managed robotically without conversion to open surgery. 41 patients experienced IAEs, with bleeding being the most common (69.6% of events). Major IAEs (4.2% of cases) led to significantly increased blood loss (average 1211 ml vs. […]
Category: Upper Gastrointestinal Tract
Predictors of DVT After Gastric or Colorectal Surgery Identified
A nomogram can help predict early postoperative deep vein thrombosis (DVT) in gastric and colorectal cancer patients despite routine anticoagulant prophylaxis. In this study of 388 patients, 32% had DVT detected by screening, predominantly asymptomatic distal DVT. Key predictors for DVT included age, activated partial thromboplastin time, prothrombin time, and postoperative day 1 d-dimer. The […]
Achalasia Treatment: Heller’s Myotomy and POEM Lead Success
This systematic review shows that Heller’s myotomy and peroral endoscopic myotomy (POEM) outperform botulinum toxin for long-term symptom relief in primary achalasia. At 5 years, Heller’s myotomy and POEM have a treatment success rate that is significantly greater than botulinum toxin (odds ratios of 6.39 and 6.33, respectively). Botulinum toxin showed less treatment success at […]
Neoadjuvant Chemoradiation Improves Pathologic Response in ESCC
Neoadjuvant chemoradiation-immunotherapy offers better pathologic complete response rates compared to neoadjuvant chemoimmunotherapy alone in patients with locally advanced esophageal squamous cell carcinoma, but it comes with increased postoperative pulmonary complications without improving long-term survival. Pathologic complete response (PCR) for nCRI was 41.1% vs. 19.4% for nCIT (p < 0.001). Postoperative pulmonary complications were significantly higher […]
Neoadjuvant Chemoimmunotherapy Improves Survival in Esophageal Cancer
In patients with locally advanced esophageal squamous cell carcinoma, neoadjuvant chemoimmunotherapy (ncit) significantly improves three-year overall survival compared to standard chemoradiotherapy (ncrt). Three-year overall survival rate was 79.7% for ncit versus 68.2% for ncrt (HR 0.51, p = 0.023). ncit also showed lower rates of overall recurrence (15.8% vs 28.8%, p = 0.033) and distant […]
Nomogram Identifies Early Recurrence Factors After Gastrectomy
A new study identifies key predictors of early recurrence in gastric cancer patients after curative gastrectomy, developed specifically for a non-East Asian cohort. Among 367 patients, the early recurrence rate was 18.3%, linked to variables including perineural invasion and elevated CA 19-9 levels. A nomogram developed from postoperative data achieved an AUC of 0.826, aiding […]
Salvage Surgery After Proton Beam Chemoradiotherapy for Esophageal Cancer
Salvage surgery for esophageal squamous cell carcinoma after proton beam chemoradiotherapy shows significant morbidity but no operative mortality, indicating careful patient selection is crucial. In a study of 19 patients, major morbidity was reported in 47.3% post-salvage surgery, with a median overall survival of 16.2 months. The 1-, 3-, and 5-year overall survival rates were […]
Patterns of Lymph Node Metastases in Esophageal Cancer Reveal New Challenges
A recent study shows extensive lymph node metastases in esophageal carcinoma despite multimodality therapy, highlighting implications for surgical strategy. Lymph node metastases were found in 42% of patients, with a median of two positive nodes. Metastases were most common in the left gastric artery (22%), right paracardial (15%), and mediastinal regions. Ongoing systematic two-field lymphadenectomy […]
Antireflux surgery holds up in severe obesity
In 2,388 patients undergoing fundoplication or magnetic sphincter augmentation for reflux disease, body mass index of 35 or higher did not worsen symptom relief, medication independence, or five-year durability. Obese patients had larger hiatal hernias and more severe reflux before surgery. At 1 year, satisfaction was 81.6% versus 83.3%, and proton-pump inhibitor independence was 85.1% […]
Developing a Reliable Assessment Tool for Esophageal Surgery
A new competency assessment tool for magnetic sphincter augmentation enhances surgical quality assurance in esophageal procedures. The Magnetic Sphincter Augmentation Competency Assessment Tool (MSA CAT) shows strong interassessor reliability with a mean Cohen’s kappa of 0.785. Intra-assessor reliability is also robust at 0.745, reflecting consistent evaluation skills among reviewers. This tool could improve patient outcomes […]