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Upper Gastrointestinal Tract

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Ann Surg5 Mar 2024

Sizing Protocol Does Not Impact Outcomes of Magnetic Sphincter Augmentation

Sizing protocol (pop+2 vs pop+3) in magnetic sphincter augmentation did not impact outcomes like dysphagia, ph normalization, or need for dilation or removal. Upsizing did benefit patients with poor peristalsis or hypercontractile esophagus. Device size increase correlated with demographic and preoperative characteristics, suggesting it is…

Upper Gastrointestinal Tract5 Mar 2024

Key Advances in Multimodality Management of Gastroesophageal Cancers

Recent studies have confirmed the long-term safety and efficacy of laparoscopic distal gastrectomy compared to open gastrectomy for locally advanced gastric cancer. Ongoing trials are evaluating perioperative immunotherapy for resectable gastric cancers. Key trials like dante, gercor neonipiga, keynote-859, and spotlight are exploring targeted therapies…

World J Surg4 Mar 2024

Optimal Extent of Lymph Node Dissection for High-Risk Gastric Cancer

High-risk gastric cancer patients may benefit from limited lymph node dissection (LND), while standard LND improves relapse-free survival in low-risk patients. Limited LND reduces postoperative complications in low-risk patients, without affecting outcomes in high-risk patients. Pancreatic fistula was not observed in the limited dissection group,…

Br J Surg3 Mar 2024

Prognostic value of tumour response and nodal status in oesophageal adenocarcinoma

Researchers found that higher Mandard score and residual nodal disease were associated with increased recurrence rates and worse overall survival in patients with oesophageal adenocarcinoma. Patients with better tumour response (trg1) had lower recurrence rates and longer overall survival compared to those with poorer response…

Surg Endosc3 Mar 2024

Task-Specific Metrics for Laparoscopic Fundoplication in Hiatal Hernia Repair

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…

Eur J Surg Oncol3 Mar 2024

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.…

Ann Surg2 Mar 2024

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…

Ann Surg2 Mar 2024

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…