Uniportal robotic-assisted minimally invasive esophagectomy is a safe option for esophageal cancer patients, showing strong early outcomes. Complete resection achieved in 95% of cases, with low conversion rate (5%). Median operative time was 155 minutes with an average blood loss of 450 ml. Consider this technique for suitable patients, as it supports quicker recovery and […]
Category: Upper Gastrointestinal Tract
Quantitative Imaging Cuts Esophageal Surgery Leakage Risk
Intraoperative quantitative blood flow measurement significantly reduces anastomotic leakage in esophageal cancer surgery. Patients using SPY-QP imaging had lower overall complication rates and less postoperative leakage. They experienced a shorter hospital stay and less intraoperative blood loss. Quantitative assessment helps optimize anastomotic site selection, improving patient outcomes. The quantitative group had more preoperative chemotherapy and […]
Pathological insights after neoadjuvant treatment for esophageal cancer
One-third of patients with locally advanced esophageal cancer show a complete clinical response to neoadjuvant chemoradiotherapy, but managing uncertain responses is critical for surgical success. Only 15% of patients with uncertain tumor response achieved a complete pathological response after esophagectomy. Complete response rates varied: 26% for non-traversable lesions, 10% for high-grade dysplasia, and 8% for […]
Toupet vs. fundopexy: fewer reoperations with fundopexy
Fundoplication options show noteworthy differences in recurrence rates and patient outcomes. Fewer symptomatic recurrences after fundopexy: 1.3% vs. 17.3% for toupet over 66 months. Comparable rates of postoperative dilation for dysphagia: 21.3% for toupet, 13.3% for fundopexy. Consider fundopexy for patients at risk of recurrence; randomized studies are needed to confirm these findings. Similar complication […]
POEM and LHD show similar long-term outcomes for achalasia.
At 5 years, 87.3% of POEM and 90.1% of LHD patients had an Eckardt score ≤3. POEM patients had a higher need for PPIs (45.6% vs 24.6%) and increased rates of esophagitis (34% vs 10.4%). Surgeons should consider the higher GERD incidence with POEM when selecting treatment. Symptomatic recurrence at 5 years was low in […]
Muscle Loss Impacts Survival in Advanced Esophageal Cancer
Excessive muscle loss during neoadjuvant therapy significantly predicts survival outcomes in locally advanced esophageal squamous cell carcinoma. Among 421 patients, 5-year overall survival was 60%, with 26.6% experiencing muscle loss during the initial treatment. Muscle loss at two points during therapy was linked to a higher risk of mortality (stage A HR 1.78; stage B […]
Outcomes Similar for Immune Therapy After Nivolumab in Esophageal Cancer
First-line immune checkpoint inhibitor therapy for esophageal cancer recurrence shows no advantage based on prior adjuvant nivolumab treatment. Among 81 patients, early tumor shrinkage rates were similar between those with and without prior nivolumab exposure. No differences in progression-free survival (HR 1.4) or overall survival (HR 1.23), with 2-year overall survival at approximately 44%. This […]
Standardized Endoscopy Could Improve Gastric Cancer Outcomes
Diagnostic endoscopy for gastric cancer is underused, leading to late-stage diagnoses and worse survival rates. 73% of stage I gastric cancer patients are symptomatic, yet many are diagnosed late. Median overall survival varies drastically: 47 months for stage II versus 11 months for stage IV. Surgeons should advocate for standardized endoscopy protocols to improve early […]
Endoscopic dissection proves effective for early esophageal cancer
Endoscopic submucosal dissection (ESD) can be a viable option for patients with esophageal squamous high-grade dysplasia and early squamous cell carcinoma, challenging the conventional referral for surgical intervention. Curative resection rates were significantly higher for absolute criteria lesions at 71.8%, compared to just 19.4% for outside criteria lesions. Of the outside criteria group, nearly 20% […]
Endoscopic and Surgical Advances in Achalasia Treatment
Minimally invasive strategies are transforming achalasia management. Laparoscopic myotomy, POEM, and emerging techniques like peroral oesophageal plication show promising outcomes. Individualized treatment based on high-resolution manometry, patient co-morbidities, and procedural risks is now essential. Comprehensive treatment offers significant symptom relief and quality-of-life improvement. Addressing post-treatment reflux and surveillance for malignancy remains critical for long-term patient […]