In a study involving 237 patients undergoing per oral endoscopic myotomy (POEM), researchers found that while achalasia type was not predictive of the need for further interventions or symptom relief, a higher integrated relaxation pressure (IRP) on preoperative manometry was associated with greater postoperative symptom improvement, indicated by reduced Eckardt scores (p=0.03). This suggests that […]
Category: Upper Gastrointestinal Tract
Flexible endoscopic treatment for Zenker’s diverticulum proves effective
A multicenter study involving 327 patients demonstrated that flexible endoscopic treatment for Zenker’s diverticulum exhibits high success rates, achieving technical success of 99.2% and clinical success of 97.4%. While the rates of adverse events and re-admissions were reported at 11.2% and 16.7%, respectively, the mortality rate remained low at 0.3%. Importantly, the study found no […]
Concomitant hiatal hernia repair with TIF shows promise for GERD
A systematic review of seven observational studies involving 306 patients found that concomitant hiatal hernia repair with transoral incisionless fundoplication (CTIF) is a viable alternative for refractory gastroesophageal reflux disease (GERD). The study highlighted a median proton pump inhibitor discontinuation rate of 73.8% and notable improvements in validated GERD questionnaires. Complications were low, with a […]
Biosynthetic mesh significantly lowers hernia recurrence rates.
In a study involving 503 patients undergoing robotic hiatal and paraesophageal hernia repair, the use of biosynthetic mesh significantly reduced long-term anatomic hernia recurrence rates from 44.9% to 24.7% compared to suture-only repairs. Symptomatic recurrence also decreased from 42.2% to 17.2%. Despite comparable short-term outcomes, the findings advocate for biosynthetic mesh reinforcement in managing medium […]
Totally mechanical Collard technique reduces anastomotic stricture rates
The totally mechanical Collard technique significantly lowers anastomotic stricture rates in cervical esophagogastric anastomosis compared to the triangular technique during minimally invasive esophagectomy. In a matched-cohort study of 117 patients, researchers found that the incidence of stricture was 2.5% in the Collard group versus 27.5% in the triangular group (p = 0.003). Other postoperative complications, […]
Minimally invasive surgery offers reliable outcomes for duodenal adenocarcinoma.
In a multicenter retrospective study involving 2,189 patients, researchers found that radical surgery significantly improved overall survival rates for duodenal adenocarcinoma, with 1-, 3-, and 5-year survival rates at 91.78%, 69.30%, and 55.86%, respectively. The median overall survival was 73 months. Notably, minimal differences in survival were observed between laparotomy and minimally invasive approaches, though […]
New diagnostic system enhances early gastric cancer detection
An innovative diagnostic system combining color change patterns with vessel classification significantly improved early gastric cancer (EGC) detection. The pink microsurface microvascular (PSV) system outperformed the traditional vessel plus surface (VS) system, achieving 93% accuracy compared to 84.6% for VS. Additionally, the PSV system’s specificity reached 93.4%, surpassing the VS system’s 83.6%. While sensitivity remained […]
Mediastinoscopy-assisted esophagectomy shows shorter operation times and fewer complications
A meta-analysis of 21 studies comparing mediastinoscopy-assisted esophagectomy (MAE) and thoracoscope-assisted esophagectomy (TAE) reveals MAE’s advantages in reducing operation times and intraoperative blood loss, while enhancing postoperative recovery due to fewer pulmonary complications. However, MAE increases the risk of recurrent laryngeal nerve injury and involves fewer lymph nodes dissected. Long-term survival rates remain statistically similar […]
Morbidity and mortality rates are low after antireflux surgery
A study of 2,342 patients undergoing antireflux and hiatal hernia surgery revealed a 30-day morbidity rate of 18.2% and a mortality rate of 0.2%. Most complications were minor, with 13.1% classified as Clavien-Dindo grade less than 3a. In the following 31 to 90 days, morbidity decreased to 3.1% and mortality to 0.09%. Findings indicate that […]
Modified outcomes enhance prognosis for elderly gastric cancer patients
A modified textbook outcome (MTO) was developed for elderly gastric cancer patients, revealing strong correlations between surgical approaches and overall survival (OS). Analysis of 1,389 patients established key factors impacting OS, including MTO, tumor size, pTNM staging, and adjuvant chemotherapy. The nomogram created demonstrated robust predictive accuracy for 1-, 3-, and 5-year OS, with AUC […]