Achieving complete pathologic response in esophageal adenocarcinoma is linked to a notable survival benefit. Among 16,169 patients analyzed, 11.4% achieved this response, rising to 17.5% in those diagnosed from 2016 to 2020. Key independent predictors included female sex, black race, Hispanic ethnicity, and clinical stage II disease, while clinical stage III correlated with lower response […]
Category: Upper Gastrointestinal Tract
Skeletal muscle quality changes predict prognosis in gastric cancer
Changes in skeletal muscle quality (δmimac) post-gastrectomy were associated with prognosis in early gastric cancer (EGC) patients, contrary to body weight (δbw) changes. Statistical analyses demonstrated that δmimac was significantly correlated with survival outcomes (p = 0.037), while δbw was not (p = 0.243). The severely decreased mimac group exhibited poorer prognosis (p = 0.030), […]
Neoadjuvant immunochemotherapy improves outcomes for gastric cancer patients
Neoadjuvant immunochemotherapy (nict) demonstrated significant advantages over neoadjuvant chemotherapy (nct) in patients with locally advanced gastric cancer. The nict group showed higher objective response rates (79.5% vs. 59.0%) and lower early recurrence rates (29.7% vs. 40.8%). While surgical complications were similar between both treatments, nict led to better pathological response rates and acted as an […]
Totally laparoscopic distal gastrectomy shows advantages over laparoscopy-assisted method
In a randomized controlled trial involving 442 patients with stage I gastric cancer, totally laparoscopic distal gastrectomy (TLDG) and laparoscopy-assisted distal gastrectomy (LADG) were compared. Although the overall complication rates were similar (12.2% vs. 17.2%), TLDG resulted in significantly lower rates of postoperative ileus (0.9% vs. 5.7%) and pulmonary complications (0.5% vs. 4.3%). Additionally, patients […]
Surgeon experience influences intraoperative efficiency and complication rates.
High-experience surgeons significantly outperform their low-experience counterparts, operating more efficiently on complex cases, with shorter intraoperative times (115.8 vs 172.9 min) and fewer complications (4.5% vs 1.8%). Low-experience surgeons handle more emergent and urgent cases, often involving older patients with greater comorbidities. Despite increased complication rates, long-term outcomes such as hernia recurrence and redo-operations are […]
Intraoperative ICG-guided Lymphography Reduces Chyle Leak Incidence
Indocyanine-green (ICG)-guided lymphography during minimally invasive esophagectomy significantly decreased the incidence of postoperative chyle leak from 11.8% to 4.6% (p=0.026). Additionally, it was linked to a shorter median hospital stay of 9 days compared to 13 days in patients without ICG guidance (p=0.006). Although chyle leaks post-ICG were more likely to necessitate reoperation (p=0.050), the […]
Implementing a critical view reduces recurrence in hernia repairs
A novel critical view approach in paraesophageal hernia repair yielded significant outcomes. Patients experiencing this technique had a recurrence rate of 9.7% versus 20% for standard repair (p < 0.01) and reoperation rates of 0.5% compared to 10% (p < 0.001). Adjusted outcomes also indicated a lower odds of postoperative complications for the critical view […]
Intracorporeal triangular anastomosis enhances robotic gastrectomy safety
The study evaluated the intracorporeal triangular anastomotic technique (INTACT) in robotic distal gastrectomy (RDG) with Billroth I reconstruction, involving 81 patients aged 31 to 91 years. Results showed median blood loss was 0 ml, and postoperative stays averaged 8 days. Importantly, there were no incidences of reanastomosis, anastomotic leakage, reoperations, or strictures. With enhanced precision […]
Staging laparoscopy improves diagnosis of incurable gastric cancer.
A population-based study indicates that staging laparoscopy in gastric cancer patients increased from 19.6% in 2016 to 32.3% in 2021 (p
Gastric stimulator improves outcomes after pyloroplasty failure.
Patients undergoing pyloroplasty for gastroparesis showed significant symptom improvement, with a GCSI score reduction from 3.5 to 2.7 at 18.7 months. However, 28.8% required gastric stimulation due to inadequate recovery. Patients who needed adjunct stimulation were younger and had higher baseline GCSI scores. Following gastric stimulation, GCSI scores improved from 4.1 to 2.6, demonstrating comparable […]