A study of 1,834 patients revealed a significant increase in the adoption of robotic surgery for hiatal and paraesophageal hernia repairs. Robotic techniques led to superior symptom resolution compared to open surgery, especially in larger hernias. Although overall rates for recurrence and reoperation remained low, robotic surgery exhibited a higher recurrence rate for large hernias […]
Category: Upper Gastrointestinal Tract
Lifestyle choices influence long-term survival post-gastric cancer surgery
A population-based study of 71,014 gastric cancer patients revealed that lifestyle behaviors significantly impact long-term mortality after curative gastrectomy, despite not affecting late recurrence. Notably, current underweight status and continued smoking increased mortality risk, while regular physical activity and maintaining a higher BMI post-surgery correlated with reduced mortality. Among the cohort, 8.1% experienced late recurrence, […]
Prehabilitation reduces postoperative pneumonia in esophagogastric surgery
A multimodal prehabilitation regimen improved postoperative outcomes for patients undergoing esophagogastric cancer surgery. Of 94 participants analyzed, those who completed at least 2 weeks of structured prehabilitation showcased a significant reduction in postoperative pneumonia compared to the control group. This research underscores the importance of tailored prehabilitation strategies in enhancing recovery and addressing complications in […]
Desflurane anaesthesia linked to better respiratory outcomes post-oesophagectomy
A retrospective study analyzed 21,080 patients undergoing oesophagectomy, revealing that desflurane anaesthesia resulted in lower rates of respiratory complications and ventilatory failure compared to sevoflurane and propofol. Patients receiving sevoflurane and propofol had significantly higher incidences of respiratory issues, with odds ratios of 1.13 and 1.43, respectively. Additionally, in-hospital mortality rates were lowest in the […]
Tumor response to neoadjuvant therapy predicts adjuvant chemotherapy benefits
In an analysis of 1887 patients with gastro-oesophageal cancer, only those with a partial response to neoadjuvant FLOT chemotherapy showed significant improvements in disease-free survival (DFS) and overall survival (OS) when treated with adjuvant FLOT. Patients categorized as minimal responders or complete responders did not benefit from additional chemotherapy. This study suggests that assessing pathological […]
Post-treatment ctDNA and PET/CT predict response in esophageal cancer.
A prospective study involving 123 esophageal squamous cell carcinoma patients demonstrates that post-treatment circulating tumor DNA (ctDNA) and PET/CT metrics can effectively differentiate those with pathological complete response (pCR) from non-pCR patients. The model, integrating ctDNA concentration and mean standardized uptake value (SUVmean), achieved areas under curves of 0.860 and 0.798 in discovery and validation […]
Minimally invasive techniques enhance outcomes in esophageal cancer surgery
A study reveals that minimally invasive esophagectomy (MIE) and robotic-assisted minimally invasive esophagectomy (RAMIE) significantly reduce postoperative pain and pulmonary infections compared to traditional surgery. Both techniques, requiring specialized training, demonstrate improved short-term outcomes and comparable oncological results to open esophagectomy. The robotic-assisted approach offers potential additional benefits pending further randomized controlled trials, suggesting a […]
Oligometastatic disease may benefit from aggressive multimodal therapy.
Oligometastatic patients with esophageal, gastro-esophageal junction, and gastric cancers experience improved outcomes with aggressive multimodal therapies. Research indicates that combining systemic therapy with surgical resection of primary tumors and metastases enhances prognosis. Notably, patients with oligometastatic cancer at the esophago-gastric junction showed potential for curative treatment. These findings suggest that current treatment paradigms should be […]
Immunotherapy expands treatment options for esophageal cancer.
Recent advancements in immunotherapy provide new treatment avenues for advanced esophageal cancer, particularly for squamous cell carcinoma and esophagogastric adenocarcinoma. Immune checkpoint inhibitors, such as nivolumab and pembrolizumab, are now approved in various treatment settings, including adjuvant therapy for patients post-surgery and first-line treatments combined with chemotherapy. These developments improve accessibility to effective therapies, regardless […]
Spray coagulation mode enhances endoscopic dissection success
A multicenter trial revealed that spray coagulation mode endoscopic submucosal dissection (scm-esd) significantly improved completion rates for treating early gastric neoplasms without the use of hemostatic forceps, achieving 83.1% versus 13.8% for conventional forced coagulation mode (fcm-esd). Procedure time and adverse event rates were comparable between the two techniques. These findings suggest that scm-esd can […]
