Higher-level care at hospitals participating in the ACS NSQIP targeted registry significantly improves esophagectomy outcomes. Analysis indicated targeted centers had a lower mortality rate (2% vs. 4%) and failure-to-rescue rate (11% vs. 17%), alongside a greater likelihood of optimal outcomes (62% vs. 58%). Notably, Ivor Lewis esophagectomies at these facilities were linked to approximately half […]
Category: Upper Gastrointestinal Tract
Proximal gastrectomy with double-tract offers viable surgical option.
The meta-analysis examined outcomes of proximal gastrectomy versus total gastrectomy in 1154 patients. Results indicated that while proximal gastrectomy had a slightly longer operating time, it yielded better results in hemoglobin levels and reduced need for vitamin B12 supplementation. Early and late-phase complications were comparable between both groups. Importantly, the 5-year overall survival rates were […]
Lymph node metastasis differs significantly between gastric carcinoma types.
A study of 891 Chinese patients revealed distinct risk factors for lymph node metastasis (LNM) and prognosis in submucosal early gastric cardiac (SEGCC) versus noncardiac (SEGNCC) carcinomas. Elderly patients and specific tumor characteristics were more prevalent in SEGCC, which correlated with poorer prognoses. Univariate and multivariate analyses identified female sex and lymphovascular invasion as key […]
Single-vessel transection reconstruction reduces surgery time and bleeding
The clinical study revealed that single-vessel transection Roux-en-Y reconstruction following total gastrectomy significantly shortened operation time (162.5 min vs. 178.5 min) and reduced intraoperative bleeding (167.2 ml vs. 207.8 ml) compared to conventional Roux-en-Y reconstruction in patients with proximal gastric cancer. No notable differences were found in baseline characteristics, mesentery tension, peritoneal drainage durations, postoperative […]
Late Oral Feeding Enhances Nutritional Status Post-Esophagectomy
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: […]
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 […]