Patients with locally advanced gastric cancer often require multivisceral resection to achieve complete tumor removal. A systematic review of 30 studies including 3362 patients showed that R0 resection was achieved in 67.77% of cases, with the spleen, colon, and pancreas being the most frequently resected organs. The most common postoperative complications were pancreatic fistulae, intraabdominal […]
Category: Upper Gastrointestinal Tract
High Incidence of Pancreatic Exocrine Insufficiency After Non-Pancreatic Upper Gastrointestinal Surgery: Implications for Enzyme Replacement Therapy
Approximately 36% of patients who undergo non-pancreatic upper gastrointestinal surgeries develop pancreatic exocrine insufficiency (PEI), which can have detrimental effects on their health. The incidence of PEI was found to be 23% after bariatric metabolic surgery and 50.4% after oesophagogastric resection, with even higher rates after certain procedures. Diagnostic testing using fecal elastase 1 was […]
Management and Prognosis of Gastric Neuroendocrine Tumors
Gastric neuroendocrine tumors (G-NETs) are rare tumors originating from the gastric mucosa, classified into three subtypes based on their characteristics and behavior. Type 1 and 2 are typically multifocal and associated with elevated serum gastrin levels. Type 2 causes symptoms like abdominal pain and diarrhea. Type 3, sporadic and solitary, has the most aggressive phenotype. […]
High-resolution 3D CT Aids in Hiatal Hernia Diagnosis and Surgical Planning
The study demonstrates that high-resolution 3D computed tomography (CT) is a valuable tool for assessing the anatomical characteristics of hiatal hernias (HH) and aiding in surgical planning for laparoscopic or robotic antireflux procedures. CT scans accurately identified HH in 70% of patients and correlated well with endoscopic findings. Furthermore, the distance between the esophagogastric junction […]
Optimal extent of lymphadenectomy in esophageal cancer surgery: Controversy and evidence
The current curative multimodal treatment of advanced esophageal cancers includes neoadjuvant or perioperative chemo(radio)therapy and radical surgical resection with a 2- or 3-field lymphadenectomy. Lymph node involvement is a significant predictor of long-term survival in esophageal cancer patients. The distribution pattern of lymph node metastases is unpredictable and depends on various factors. The extent of […]
Neoadjuvant Radiation and Pulmonary Complications in Esophagectomy: Impact only in Pre-existing Pulmonary Disease
Patients undergoing esophagectomy for malignancy often experience post-operative pulmonary complications (POPC), and this study aimed to investigate if neoadjuvant radiation therapy contributes to their incidence. The analysis of database files revealed no consistent association between neoadjuvant radiation and POPC in all patients. However, in those with pre-existing pulmonary disease (PEPD), neoadjuvant chemoradiotherapy resulted in a […]
Successful Fistula Closure Achieved through Surgical Management in Complex Duodenal Fistulas
This retrospective study analyzed the management options and outcomes of 50 adult patients with complex duodenal fistulas. Surgical closure combined with duodenal decompression yielded the highest success rate, with 76% of patients achieving fistula closure. In selected cases, nonoperative management was attempted, resulting in closure without surgery in 5 out of 6 patients. However, eventually […]
Higher Lymph Node Count Improves Survival in Stage III Gastric Cancer Patients After Surgery
Analysis of 2373 stage III gastric cancer patients who underwent curative gastrectomy revealed that a higher count of negative lymph nodes (NLN) (>14) significantly improved the 5-year overall survival rate compared to patients with a lower count (43.7% vs 23.1%). This study establishes NLN count as an independent prognostic factor for stage III gastric cancer […]
Lymph Node Tumor Regression Grade (lntrg) is a Better Prognostic Indicator for Esophageal Squamous Cell Carcinoma
Comparing different staging categories for esophageal squamous cell carcinoma, this study determined that lymph node tumor regression grade (lntrg) demonstrated superior prognostic value for disease-free survival prediction compared to pretreatment pathologic n stage (prepn) and posttreatment pathologic n (ypn) categories. lntrg showed significant prognostic stratification power and was an independent prognostic factor. Multivariable cox regression […]
Indocyanine green fluorescence-guided lymphadenectomy improves lymph node retrieval in gastric cancer
The study evaluated the impact of indocyanine green (ICG) fluorescence-guided lymphadenectomy during laparoscopic gastrectomy for gastric cancer. It included 142 patients, with 42 receiving preoperative ICG injection. The ICG group exhibited a higher number of retrieved lymph nodes compared to the non-ICG group, regardless of neoadjuvant treatment or tumor stage. The use of ICG was […]