Researchers lit up esophageal cancer surgery with near-infrared indocyanine green, exposing the elusive thoracic duct (TD) in 94% of cases. Injecting ICG into inguinal nodes during minimal access esophagectomy, the team showcased real-time TD imaging. The glow guided ligation in 16 cases, minimizing chyle leaks and sidestepping adverse reactions. This illuminating approach, sustaining fluorescence throughout, […]
Category: Upper Gastrointestinal Tract
Unsupervised Training Proves Effective for Esophago-Gastric Endoscopic Submucosal Dissection
Experienced endoscopists seeking competence in endoscopic submucosal dissection (ESD) faced a challenging learning curve. This study introduced an unsupervised training model. Endoscopists initially observed 30 ESD cases and performed 15 unsupervised ex-vivo ESDs. Afterward, they tackled five human distal gastric ESDs and 55 unselected esophago-gastric cases. Results were promising, with a 93.0% en-bloc resection rate, […]
Navigating Complications in Laparoscopic vs. Open D2-Gastrectomy (LOGICA Trial): Comprehensive Index Offers No Extra Perks
Researchers delved into the LOGICA trial, scrutinizing complications after gastric cancer surgery. Comparing Comprehensive Complication Index (CCI) and Clavien-Dindo Classification (CDC), they discovered no significant difference in complication burden between laparoscopic and open D2-gastrectomy. The verdict? While both indices correlated for hospitalization, ICU-stay, and reoperations, the CCI brought no extra flair, advising against its use […]
New Surgical Guidelines for Paraesophageal Hernias Offer Key Recommendations
The European Association for Endoscopic Surgery conducted a comprehensive review to update guidelines for paraesophageal hernias. They gathered an interdisciplinary panel of experts, including surgeons, gastroenterologists, and patient advocates, and utilized the latest evidence and methodology. Their recommendations emphasize surgery for asymptomatic/minimally symptomatic cases but recommend conservative management for frail patients. They also provide guidance […]
Sequential Treatment Outperforms Open Abdomen Approach for Duodenal Leakage-Induced Intra-Abdominal Bleeding
A cohort study examined treatments for intra-abdominal bleeding caused by duodenal leakage. The two approaches were “Sequential Treatment” (ST), which combines arterial embolization and drainage, and “Open Abdomen” (OA), a simultaneous method. ST had a lower mortality rate (28.2% vs. 51.3%) and better initial hemostasis success (94.4% vs. 77.8%) compared to OA. After propensity score […]
Enhancing Outcomes in Esophagectomy Patients: A Multi-Pronged Approach
Esophagectomy, a complex cancer surgery, poses substantial risks of major complications and death. To optimize patient outcomes, modern strategies focus on preventing and treating specific complications, implementing enhanced recovery practices, conducting thorough clinical and physiological risk assessments, involving high-volume surgical teams, and providing multimodal support. These approaches aim to safeguard and restore nutritional status, muscle […]
Unsupervised Training Proves Effective for Esophago-Gastric Endoscopic Submucosal Dissection
Experienced endoscopists seeking competence in endoscopic submucosal dissection (ESD) faced a challenging learning curve. This study introduced an unsupervised training model. Endoscopists initially observed 30 ESD cases and performed 15 unsupervised ex-vivo ESDs. Afterward, they tackled five human distal gastric ESDs and 55 unselected esophago-gastric cases. Results were promising, with a 93.0% en-bloc resection rate, […]
Neoadjuvant Therapy Benefits Esophageal Adenocarcinoma Patients
In a study involving 3,413 patients with cT2N0M0 esophageal adenocarcinoma, researchers investigated the impact of neoadjuvant chemoradiotherapy (NT) on surgical outcomes and oncological benefits for those with clinical stage IIA disease. The study found that NT did not adversely affect perioperative outcomes compared to upfront surgery. Moreover, minimally invasive esophagectomy after NT was feasible, and […]
Optimizing Lymph Node Surgery for Duodenal Cancer Improves Patient Outcomes
In patients with non-ampullary duodenal adenocarcinoma (NADAC), researchers studied the extent of regional lymphadenectomy based on tumor location and its effect on survival. They found that certain lymph nodes, such as those near the pancreas and superior mesenteric artery, were frequently affected by metastasis. Implementing number-based nodal classification, they identified key regional nodes, allowing for […]
Preserving Bronchial Arteries Reduces Postoperative Pneumonia After Esophagectomy
This study explored the impact of preserving bronchial arteries during radical esophagectomy, a surgical procedure for esophageal cancer, on the incidence of postoperative pneumonia. Researchers analyzed 348 patients and found that preserving bronchial arteries was associated with a decreased risk of postoperative pneumonia. They also identified factors like smoking history and lung function as additional […]