Preoperative chemotherapy significantly increased overall survival in patients with liver-limited metastasis from gastric cancer who underwent hepatectomy, compared to upfront surgery. Patients who exhibited a partial response to preoperative chemotherapy had better outcomes than those with stable or progressive disease. The preoperative chemotherapy group also had a higher chance of undergoing surgical resection for recurrent […]
Category: Upper Gastrointestinal Tract
Robot-assisted gastrectomy boosts textbook outcomes and nutritional status in malnourished gastric cancer patients.
Robot-assisted gastrectomy (RAG) outperformed laparoscopic-assisted gastrectomy (LAG) in malnourished gastric cancer patients in terms of achieving a textbook outcome (TO), with higher operative time, lymph nodes harvested, and lower blood loss and hospital stay. RAG was an independent protective factor for TO, leading to better adjuvant chemotherapy compliance, faster nutritional recovery, and increased malnutrition reversal […]
Substantial Increase in Gastric Surgery Volume During General Surgery Residency Training in the US
General surgery residents in the US have experienced a significant increase in gastric surgery volume from 2009 to 2022, mainly driven by a rise in laparoscopic gastric reduction for morbid obesity. There was also a notable growth in laparoscopic partial gastric resections, repair of gastric perforation, and “other major stomach procedures,” while open gastrostomy, open […]
Robotic surgery in foregut procedures
Comparing robotic and laparoscopic approaches in hiatal hernia repair and Heller myotomy, robotic surgery showed non-significantly shorter hospital stays, fewer conversions to open, and lower morbidity rates for hhr, while hm had significantly fewer esophageal perforations, reinterventions, and a non-significantly shorter stay. Both robotic procedures had longer operative times. Safety profiles and perioperative outcomes were […]
Hybrid Surgical Approach in Esophageal Cancer: Real-World Validation of MIRO Trial
A national cohort study validated the external validity of the MIRO randomized controlled trial in a real-life population within France by comparing postoperative complications in esophageal cancer patients. The hybrid approach was found to be protective against severe respiratory complications, with no significant difference in 30-day mortality or leakage rate between surgical approaches. Journal Article […]
Low Rates of Metastases in Mucosal Esophageal Adenocarcinoma with Poor Differentiation
Patients with mucosal esophageal adenocarcinoma and poor differentiation had low rates of metastases after endoscopic resection, even when additional risk factors were present. Metastasis rates were 4.0% for single risk factor patients and 20.0% for those with additional risk factors. Overall death rates were 28.0% and 20.0% for the respective groups. A conservative approach may […]
Esophagectomy improves 5-year overall survival in locally advanced esophageal adenocarcinoma
Esophagectomy is associated with improved 5-year overall survival in locally advanced esophageal adenocarcinoma. Factors like age, race, treatment location, insurance, and tumor size influence esophagectomy use. Non-surgical treatment, government insurance, low income, non-academic centers, comorbidities, and larger tumors increase the risk of all-cause mortality. Esophagectomy and systemic therapy decrease mortality risk. Patients undergoing esophagectomy had […]
Robotic Surgery Shows Promising Results for Resectable Esophageal Cancer
Robotic surgery in esophagectomy for resectable esophageal cancer offers advantages such as reduced postoperative pain and pulmonary complications. A review of 113 studies shows that outcomes include a weighted mean postoperative pneumonia rate of 11%, anastomotic leak rate of 10%, and a 95% success rate in achieving a clear resection margin. There is a potential […]
Spectral CT and Machine Learning Improve Preoperative Prediction of Gastric Cancer Invasion
Accurate preoperative prediction of lymphovascular and perineural invasion status in gastric cancer patients is crucial for identifying high-risk individuals. This study developed and tested a machine learning model that successfully combines spectral CT parameters and clinical indicators to accurately predict LVI/PNI status. The integration of portal venous and ep spectral CT parameters significantly enhances the […]
Extended 96-hour Acid Reflux Monitoring Diagnosed More Patients with GERD Compared to Standard 48-hour Testing
Prolonged acid reflux monitoring for 96 hours diagnosed more patients with GERD compared to standard 48-hour testing. Extended monitoring led to clinically significant changes in study interpretation, with almost half of patients showing abnormal results after a normal study on day 1. Results suggest that only monitoring for 48 hours may miss a diagnosis of […]