Researchers successfully developed and validated task-specific metrics (TSM) for laparoscopic Nissen fundoplication, a critical phase in laparoscopic hiatal hernia repair (LHHR). Utilizing structured interviews with expert foregut surgeons and a simulation involving participants with varying surgical expertise, the study demonstrated high interrater reliability and significant validity evidence for both global and TSM assessments. These LHHR-specific […]
Category: Upper Gastrointestinal Tract
Esophageal Washout with Povidone-Iodine Reduces Intraluminal Tumor Cells in Carcinoma Resection
Intraoperative esophageal washout with povidone-iodine solution significantly reduces the presence of free intraluminal tumor cells during esophageal and cardiac carcinoma resection. Neoadjuvant treatment decreases the likelihood of malignant cells in the esophagus. Repetitive washout decreases detectable malignant cells, with a significant reduction after 10 maneuvers. This novel, feasible procedure can help eliminate tumor cells and […]
ICG-Guided Lymphadenectomy in LAGC: RCT Results
Indocyanine Green (ICG)-guided lymph node (LN) dissection during laparoscopic radical gastrectomy significantly improves the quality of lymphadenectomy in locally advanced gastric cancer (LAGC) patients post-neoadjuvant chemotherapy (NAC). A randomized controlled trial with 236 patients demonstrates that ICG increases LN retrieval and decreases non-compliance rates, particularly in cases without baseline measurable LNs and in those with […]
PORSHA for Paraesophageal Hernias: Phase 2a Results
Posterior Rectus Sheath Hiatal Flap Augmentation (PORSHA) exhibits promise as a surgical innovation for large and recurrent paraesophageal hernias. In a study of 27 cases, PORSHA, after technical modifications, demonstrated safety and success in repairing type III, IV, and recurrent paraesophageal hernias. At an 11-month follow-up, there were no radiologic recurrences, abdominal eventrations, or hernias […]
TSLG versus LTH for Siewert Type II AEG: Advantages and Efficacy
Transthoracic single-port-assisted laparoscopic gastrectomy (TSLG) demonstrates technical safety and feasibility in comparison to laparoscopic transhiatal approach (LTH) for Siewert type II adenocarcinoma of the esophagogastric junction. In a retrospective study, TSLG showed advantages, including increased harvested lymph nodes, reduced lower mediastinal lymph nodes, and longer proximal margins. The R0 gastrectomy rate was higher in the […]
Recurrence-Free Survival Strongly Correlates with Overall Survival in Neoadjuvant-Treated Oesophageal Squamous Cell Carcinoma
Recurrence-free survival is a valid surrogate endpoint for overall survival in surgically resectable advanced oesophageal squamous cell carcinoma (oscc) patients receiving neoadjuvant chemotherapy. A strong correlation (kendall’s τ 0.797) was found between the two endpoints, particularly in patients with a more favorable response to neoadjuvant treatment. This suggests that recurrence-free survival can be used as […]
Metastatic Lymph Nodes and Survival in Esophageal Cancer
Patients with 1 metastatic lymph node had a median overall survival of 49.8 months, while those with 2 metastatic lymph nodes had an overall survival of 33.3 months. Survival was not significantly different between patients with 1 metastatic lymph node in 1 lymph node metastasis station and those with 2 metastatic lymph nodes in the […]
Long-Term Oncologic Outcome Similar Between Proximal Gastrectomy and Total Gastrectomy for Upper-Third AGC and EGJ Cancer
Proximal gastrectomy (PG) and total gastrectomy (TG) for upper-third advanced gastric cancer (AGC) and Siewert type II esophagogastric junction (EGJ) cancers yield similar overall survival rates (61.7% vs. 68.3%) and recurrence-free survival rates (86.7% vs. 83.3%). PG group had eight recurrences, but operation method was not identified as a prognostic factor of tumor recurrence in […]
Feasibility and Safety of Minimally Invasive Gastrectomy Post-Chemotherapy
Examining minimally invasive gastrectomy post-preoperative chemotherapy for advanced gastric cancer, this study included 150 patients, assessing safety and feasibility. The overall morbidity rate was 12%, with a higher incidence in total/proximal gastrectomy plus splenectomy cases. Robotic gastrectomy, especially in cases involving splenectomy, demonstrated significantly lower postoperative complications compared to the laparoscopic approach. The findings support […]
Elective Laparoscopic Repair Improves Life Expectancy in Paraesophageal Hernia
Researchers utilized an updated Markov model to compare life-years gained with elective laparoscopic paraesophageal hernia repair (ELHR) versus watchful waiting (WW) in patients aged 40-90 with symptoms, Cameron lesions, or comorbid conditions. ELHR was found to increase life expectancy over WW in most cases, particularly in symptomatic patients. Despite the impact of comorbidities, ELHR remained […]
