Ultra-early postoperative endoscopy within 24 hours significantly reduces anastomotic leaks after minimally invasive esophagectomy (MIE). Anastomotic leak rates dropped from 20.07% to 11.31% with ultra-early endoscopy (p=0.007). Hypoproteinemia rates fell from 21.90% to 9.49% (p<0.001), and median hospital stay decreased (p=0.01). This approach safely enables earlier risk detection and promotes faster enteral nutrition, improving patient […]
Category: Upper Gastrointestinal Tract
Risk of Postoperative Pancreatic Fistula Tied to Vein Anatomy
Left gastric vein anatomy impacts the risk of pancreatic fistula after laparoscopic gastrectomy. Among 566 patients, 2.5% developed postoperative pancreatic fistula (POP). Type C vein anatomy (dorsal to the splenic artery) had a 17.9% POP rate, compared to just 1.7% for other types (p < 0.001). Consider robotic gastrectomy to reduce POP risk, especially in […]
Pocket-Creation Method Non-Inferior in Gastric ESD
The pocket-creation method for gastric tumors matches conventional techniques in safety and effectiveness, with fewer subsequent surgeries. Adverse event rates: 14.3% for pocket-creation vs. 12.9% for conventional. Significantly lower need for further surgery in pocket-creation group (2.9% vs. 12.9%, p=0.028). Consider using the pocket-creation method to reduce follow-up interventions while achieving comparable resection rates. Procedure […]
Innovative Technique Reduces Tension in Hiatal Hernia Repair
A modified technique using lateral relaxing incisions may improve outcomes in complex hiatal hernia repairs. Recurrence rates in redo patients were 12% and 18% in giant hernia cases. 84% of patients reported symptom improvement, including heartburn. This approach aims to enable tension-free repairs, particularly for those with high tension risks. Follow-up will assess long-term efficacy […]
Comparing ERCP Techniques in Billroth II Gastrectomy
Forward-viewing endoscopy with a cap shows similar efficacy to side-viewing duodenoscopy for ERCP in Billroth II patients. No significant differences in biliary cannulation or clinical success rates between the two techniques. Adverse event rates were comparable; however, post-ERCP pancreatitis rates were higher with the forward-viewing approach (14.5% vs 6.7%). Surgeons should interpret these findings cautiously […]
Improved Peritoneal Disease Detection in Advanced Gastric Cancer
Staging laparoscopy reveals peritoneal disease in over half of advanced gastric cancer patients, enhancing surgical decision-making. Peritoneal disease was found in 54.9% of patients undergoing staging laparoscopy, with positivity rates of 61.7% in type 4 lesions. The sensitivity and specificity of staging laparoscopy were 94.6% and 100%, respectively, demonstrating high diagnostic accuracy. The four-factor predictive […]
New risk scoring for achalasia post-POEM reveals critical patterns.
The JAMS POEM score effectively predicts short-term clinical failure (AUROC 0.71) but loses accuracy long-term (AUROC 0.54). A three-tiered risk stratification identifies an intermediate-risk group with a 10-year failure rate of 35.8%, suggesting different follow-up strategies. Surgeons should consider long-term outcomes when applying the JAMS POEM score for better patient surveillance. In the low-risk group, […]
Effective outcomes for laparoscopic hiatal hernia repair with cTIF
Laparoscopic hiatal hernia repair combined with consecutive transoral incisionless fundoplication (cTIF) achieves high success rates in GERD patients. 92% of patients achieved complete clinical success within 12 months. Symptom improvement was reported by 90% and 84% normalized esophageal acid exposure. Most patients (84%) stopped daily proton pump inhibitors, enhancing long-term management potential for surgeons. Serious […]
Neoadjuvant Serplulimab Improves Survival in PD-L1-Positive Gastric Cancer
Neoadjuvant serplulimab with chemotherapy enhances event-free survival in PD-L1-positive gastric cancer, making it a promising strategy for surgeons. Median event-free survival was longer with serplulimab (not reached) compared to placebo (42 months) for patients with PD-L1 CPS ≥10 (HR 0.65, p=0.0082). In the overall patient population, event-free survival was also improved (not reached vs. 35.9 […]
Laparoscopic Exploration Crucial for Assessing Occult Metastasis in Gastric Cancer
Laparoscopic exploration is vital for detecting occult peritoneal metastasis (opm) in gastric cancer, significantly impacting patient outcomes. 22.2% of 653 patients showed opm+ initially, linked to worse survival (15.9 months vs not reached). Younger age, better ECOG status, primary gastric cancers, and specific CA72-4 levels were risk factors for opm+. Re-evaluating opm status post-treatment revealed […]