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Upper Gastrointestinal Tract

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Surgical Endoscopy10 Dec 2024

Modified apprenticeship models could enhance esophageal ESD training.

Endoscopic resection techniques, like ESD, offer safer alternatives to esophagectomy for esophageal cancer. While ESD provides complete histopathological assessment, a consensus on training models remains elusive. The effectiveness of Japan's apprenticeship model contrasts with the West's comprehensive methods that combine various training approaches. Researchers suggest…

J Gastrointest Surg9 Dec 2024

Severe postoperative muscle loss links to poor outcomes in gastric cancer

A systematic review and meta-analysis revealed that 25.7% of gastric cancer patients experience severe postoperative skeletal muscle loss, which significantly correlates with poorer overall survival (OS), recurrence-free survival (RFS), disease-free survival (DFS), and disease-specific survival (DSS). Results indicate a hazard ratio of 2.27 for OS…

Medicine (Baltimore)9 Dec 2024

Plasma metabolites show causal links to gastric cancer development

A bidirectional Mendelian randomization study investigated 1400 plasma metabolites and their relationship with gastric cancer (GC). The study identified metabolites such as 3R-dihydroxybutyrate and methyl indole-3-acetate positively associated with GC, while asparagine and glucose to maltose ratio were negatively linked. Additionally, 18 significant metabolic pathways…

Gastrointest Endosc8 Dec 2024

Endoscopic Submucosal Tunneling Techniques outperform Flexible Endoscopic Septotomy

A systematic review and meta-analysis involving 759 patients revealed that endoscopic submucosal tunneling techniques (ESTT) provide a higher probability of clinical success for treating Zenker's diverticulum compared to flexible endoscopic septotomy (FES). While both methods showed similar rates of technical success, operative time, and hospital…

J Gastrointest Surg6 Dec 2024

Laparoscopic fundoplication normalizes esophageal motility in GERD patients

Laparoscopic fundoplication (LF) significantly enhances esophageal motility in gastroesophageal reflux disease (GERD) patients, despite varying motility statuses. An analysis of 124 patients revealed favorable outcomes in 103 cases post-surgery, linking successful LF to improved motility. This study, which included laparoscopic Nissen and Toupet fundoplications, demonstrated…

J Gastroenterol5 Dec 2024

New algorithm effectively identifies gastric cancer cases in Japan

A validated claims-based algorithm successfully identifies incident gastric cancer cases and determines progression phases in Japan. It demonstrated a positive predictive value of up to 95.9% and sensitivity rates reaching 98.9% in validation cohorts. This advancement enables better analysis of real-world gastric cancer scenarios, facilitating…

Eur J Surg Oncol3 Dec 2024

Anastomotic doughnut width predicts leakage risk in surgeries

A study examining anastomotic doughnuts from 102 patients found that minimal width of the oral and aboral doughnuts notably correlated with anastomotic leakage (AL) rates, which were 15.7%. The oral and aboral minimal widths were significantly lower in AL cases compared to non-Leakage cases. In…

Ann R Coll Surg Engl30 Nov 2024

Prehabilitation is deemed essential but access varies significantly.

A national survey revealed that 96% of oesophagogastric cancer centers support prehabilitation as standard care, yet only 75% currently offer it. The majority of respondents advocate for its initiation at diagnosis, highlighting its role in enhancing quality of life, physical fitness, and reducing surgical complications.…

Upper Gastrointestinal Tract26 Nov 2024

Minimally invasive surgery improves outcomes for distal gastric cancer.

A large retrospective analysis revealed that minimally invasive surgery (laparoscopic and robotic) for distal gastric cancer results in significantly lower 30-day readmission rates, mortality, and enhanced overall survival compared to open gastrectomy. While robotic techniques yielded superior lymph node yields and shortened hospital stays, the…