Italian experts recommend a symptom-based strategy for diagnosing gastroesophageal reflux disease (GERD), emphasizing the exclusion of alarm symptoms and non-GERD causes. For those with alarm features or unresponsive to standard treatments, more invasive tests like esophago-gastro-duodenoscopy are advised. Treatment protocols advocate a 4-8 week course of proton pump inhibitors (PPIs) for most patients, reserving higher […]
Category: Upper Gastrointestinal Tract
Removing 19 or More Negative Lymph Nodes Enhances Survival in Esophageal Cancer
A systematic review reveals that removing 19 or more negative lymph nodes (NLNs) during esophageal cancer surgery correlates with significantly improved survival rates, particularly in adenocarcinoma patients. Specifically, the hazard ratio indicates a 12% improved survival compared to those with fewer than 19 NLNs removed. This finding underscores the importance of surgical strategy, suggesting that […]
New techniques expand endoscopic options for gastric subepithelial lesion resection
Innovations in endoscopic resection now enable the safe removal of larger and deeper gastric subepithelial lesions (SELs), previously suitable only for surgical intervention. This article outlines various endoscopic modalities and provides crucial technical tips. In a case series, successful en bloc resections were achieved in all patients with no adverse events, demonstrating the effectiveness of […]
ICG Fluorescence Cuts Anastomotic Leakage Risk After Esophagectomy
Indocyanine green (ICG) fluorescence significantly lowered anastomotic leakage rates after esophagectomy. In a randomized trial of 92 patients, leakage occurred in only 6.7% of those who received ICG guidance compared to 21.3% in the control group, demonstrating a clear advantage. The technology identifies well-perfused areas in the gastric conduit for safer anastomosis, while no differences […]
New scoring system accurately predicts perforation risk in gastric tumor surgeries
A novel scoring system successfully identifies high-risk patients for intraoperative perforation during endoscopic resection of gastric gastrointestinal stromal tumors. Analyzing over 1,100 patients, the system considers tumor location, size, and growth pattern, achieving strong discrimination with AUCs above 0.8. Risk stratification reveals significant variations: low-risk patients face an 8.3% perforation rate, while high-risk patients experience […]
Robotic anti-reflux surgery rapidly relieves GERD symptoms long-term.
Robotic anti-reflux surgery (ARS) delivers significant relief for both typical and atypical gastroesophageal reflux disease (GERD) symptoms. Within three months, 90% of patients reported major improvements in regurgitation, heartburn, and belching. Atypical symptoms, such as cough and throat clearing, improved more slowly but showed notable reductions after a year. Key factors influencing outcomes vary, underscoring […]
Probiotics may enhance recovery and reduce complications after gastric cancer surgery
Gut microbiota alterations post-gastrectomy are linked to inflammation and complication risks. A systematic review of 13 studies encompassing 937 patients revealed reduced microbial diversity after surgery, correlating with negative surgical outcomes. Notably, oral probiotics demonstrated efficacy in restoring microbiota diversity and decreasing postoperative complications. However, consensus on which specific probiotics to use remains elusive. Focus […]
Endoscopic Submucosal Dissection Offers Hope for GERD-Related Neoplasms
Endoscopic submucosal dissection (ESD) proves highly effective in treating GERD-related neoplasms, achieving a 100% en bloc resection rate and a 95.8% curative resection rate among 96 patients. Remarkably, no local recurrences or metastases were observed during follow-ups. After six months, nearly 70% of patients experienced alleviated GERD symptoms, linked to the extent of resected lumen […]
Landmark Study Maps Esophageal Cancer Survival Rates by Stage and Treatment
A comprehensive analysis of 7,855 esophageal cancer cases in Denmark reveals crucial survival outcomes based on treatment strategies. Definitive chemoradiotherapy offers lower overall survival compared to surgery, yet outperforms palliative care. Interestingly, stage IVB patients undergoing surgery showed unexpectedly favorable survival. This research leverages the Union for International Cancer Control staging system to refine prognostic […]
Nutrition Leads in Reducing Frailty Risk for Seniors
Hypothetical interventions targeting nutrition, anxiety, and family cohesion significantly lower frailty risk among older gastric cancer patients. A single focus on nutrition proved most effective, reducing risk by 21%. Joint interventions yielded even greater results, with all-factor combinations slashing risk by over 31%. These findings underscore the importance of tailored support systems in enhancing recovery […]