Lymphadenectomy in gastric cancer treatment requires tailored approaches for different patient scenarios. Individualized decisions for lymphadenectomy are crucial based on patient factors and radiographic nodal involvement, especially in conversion and cytoreductive surgeries. Optimal lymphadenectomy extent for gastroesophageal junction cancers is driven by tumor classification and invasion length. Surgeons need to consider unique drainage patterns in […]

Surgeons should note that achieving the Textbook Outcome in gastric cancer surgery significantly enhances patient survival and reduces hospital stays. 74.7% of 5806 patients achieved the Textbook Outcome, with 87.6% 5-year survival for those who did. Success rates varied by stage: 77.9% for stage I and 68.8% for stages II-III. Older patients had lower achievement […]

Surgery for Barrett’s esophagus shows a significant regression rate, particularly in shorter segments, influencing patient management. Histologic regression occurred in 53.4% of patients overall, with 68.9% in ultrashort and 51.2% in short segments, but 0% in long-segment Barrett’s (p<0.001). Key predictors of regression included an anatomically intact repair (64.2% vs. 38.8% for disrupted, p<0.001) and […]

Higher hospital surgical volume leads to significantly better outcomes for esophagectomy and gastrectomy patients. 30-day mortality drops to 51% lower (odds ratio 0.51) at high-volume hospitals performing 4-239 resections/year. 90-day mortality reduced by 35% (odds ratio 0.65) and fewer complications observed (odds ratio 0.83). Surgical teams should consider hospital volume when planning procedures. Optimal volume […]

Conversion minimally invasive esophagectomy is a viable option for cT4b esophageal cancer patients previously deemed unresectable, offering significant benefits. Patients undergoing conversion minimally invasive esophagectomy (c-mie) experienced less intraoperative blood loss (79 ml vs. 470 ml, p < 0.001) and a lower risk of anastomotic leakage (4.8% vs. 24%, p = 0.04). ICU stays were […]

New study evaluates indocyanine green fluorescence to prevent chyle leakage during esophagectomy, but results are mixed. Chyle leakage incidence: 17% in the ICG group vs. 10% in controls (p = 0.163). ICG influenced intraoperative decisions in 36% of cases, with successful thoracic duct visualization in 85%. Surgeons may not see a reduction in chyle leakage, […]

For patients with resectable oesophageal squamous cell carcinoma, neoadjuvant chemotherapy offers significantly better survival outcomes than chemoradiotherapy after achieving a pathological complete response. Among patients achieving complete response, 5-year overall survival was 97.5% with chemotherapy vs. 70.4% with chemoradiotherapy. Recurrence-free survival also favored chemotherapy (80.8% vs. 63.7%). Consideration of watch-and-wait strategies may be warranted for […]

Choosing between tubular esophagogastric and double-tract anastomosis for older patients can affect perioperative safety and long-term quality of life. Patients aged 70+ had fewer complications with tubular esophagogastric (25.9% vs. 50.0% for double-tract, p=0.049). Double-tract anastomosis had longer operative times (232.1 min vs. 217.6 min for tubular esophagogastric, p=0.016) and better reflux control at 12 […]