Patients undergoing late oral feeding post-esophagectomy had significantly less body weight loss, higher calorie and protein intake, and lower malnutrition rates compared to those with early feeding. Complication rates and hospital stays were similar between the groups, indicating that late oral feeding may improve postoperative nutritional status without compromising surgical outcomes. • Why it matters: […]
Category: Upper Gastrointestinal Tract
AI Model Successfully Evaluates Surgical Skill in Robotic Distal Gastrectomy
An AI model effectively evaluates surgical skill in robotic distal gastrectomy (RDG) by accurately recognizing and analyzing instrument usage. Experienced surgeons demonstrated shorter durations using specific instruments during infrapyloric lymphadenectomy compared to non-experienced surgeons. This study showcases the feasibility of using AI for objective skill assessment in RDG, enhancing training and potentially improving patient outcomes […]
Robot-assisted surgery excels in lymph node dissection for oesophageal cancer
Robot-assisted oesophagectomy shows superior effectiveness in removing crucial lymph nodes near the recurrent laryngeal nerve, compared to video-assisted techniques, resulting in lower rates of nerve injury. In a multicentre trial in Asia, robot-assisted surgery successfully dissected lymph nodes in 88.3% of cases, significantly outperforming video-assisted surgery at 69%. Robot-assisted procedures also led to fewer cases […]
Additional Gastrectomy after Endoscopic Submucosal Dissection Does Not Worsen Prognosis in Early Gastric Cancer
Propensity score-matching analysis of 778 patients showed that additional gastrectomy after endoscopic submucosal dissection (ESD) for early gastric cancer did not significantly impact overall or disease-free survival rates compared to surgery alone. Postoperative complication rates were similar between groups. The findings suggest that additional gastrectomy after ESD is oncologically acceptable and does not worsen long-term […]
Malnutrition and Nutritional Support After Gastrectomy in Gastric Cancer Patients
Malnutrition, common among gastric cancer patients, can be improved with nutritional support after gastrectomy. Total gastrectomy poses significant challenges, but function-preserving surgeries show promise. Effective nutritional screening and support enhance outcomes, including reduced complications and improved quality of life. Preoperative interventions vary in effectiveness, while postoperative support consistently benefits patients. Enteral nutrition is effective for […]
Circulating Exosomal MicroRNA Panel Predicts Peritoneal Metastasis in Advanced Gastric Cancer
A circulating exosomal microRNA panel, robustly predicting peritoneal metastasis in advanced gastric cancer patients, was developed and validated with remarkable accuracy. The risk-stratification model, combined with currently used tumor markers, significantly outperformed conventional clinical factors in predicting metastasis. This novel liquid biopsy assay shows potential for improved patient selection and management, offering clinical impact in […]
Improved outcomes seen with upper gastrointestinal specialist surgeons in emergency surgeries
Emergency upper gastrointestinal surgeries show better 30-day and in-hospital mortality outcomes when performed by specialists. A systematic review and meta-analysis of 24 articles found a significant decrease in mortality rates when UGI specialists were involved. Surgeons are advised to consider early subspecialist team involvement for improved patient outcomes. Journal Article by Barbaro A, Bunjo Z […]
Grading Esophageal Perforations Improves Outcome Predictions
Severely graded esophageal perforations (grades I-IV) impact patient survival differently, with grades II-IV showing lower overall survival rates. Factors such as duration of injury >24 hours, presence of mediastinitis, and esophageal necrosis are associated with unfavorable outcomes. Grading severity based on diagnostic CT scans, endoscopic, radiological, and clinical findings helps guide treatment decisions and may […]
Omitting Drains Improves Outcomes After Peptic Ulcer Repair
Omitting intraabdominal drains post peptic ulcer repair led to earlier recovery milestones, reduced pain severity, and shorter hospital stay. The no-drain group exhibited faster bowel function return, fluid and solid diet intake, along with decreased morbidity rates such as surgical site infections and respiratory complications compared to the drain group. These findings suggest that skipping […]
Endoscopic Treatments for Gastroesophageal Reflux Disease: EBL and TIF Show Superior Efficacy
Endoscopic band ligation (EBL) and transoral incisionless fundoplication (TIF) show comparable efficacy in improving health-related quality of life in patients with GERD, outperforming other endoscopic interventions like Stretta, EFTP, and Endocinch. EBL and TIF also significantly decrease esophagitis incidence compared to PPIs. While TIF increases lower esophageal sphincter pressure, it is less effective than PPIs […]