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 […]
Category: Upper Gastrointestinal Tract
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 […]
Primary Surgeon Specialty Does Not Impact Postoperative Complications in Esophagectomy
Cardiothoracic surgeons and general surgeons perform the majority of esophagectomies, but differences in surgical techniques exist. This study analyzed data from 3,247 patients and found that cardiothoracic surgeons were more likely to use traditional minimally invasive or open approaches, while general surgeons favored robotic or hybrid approaches. However, after adjusting for risk factors, there were […]
Low inter-rater reliability and variability in assessing laparoscopic fundoplication with endoscopy
This study evaluated the inter-rater reliability and variability in assessing laparoscopic fundoplication using endoscopy. A total of 101 participants, including upper gastrointestinal surgeons and gastroenterologists, analyzed ten static endoscopic images post-fundoplication. The study found that overall accuracy was 76% for upper gastrointestinal surgeons and 69.9% for gastroenterologists. Upper gastrointestinal surgeons performed significantly better in certain […]
Improved Detection of Lymph Nodes in Esophageal Squamous Cell Carcinoma Using Indocyanine Green-Near-Infrared Fluorescence Imaging
Indocyanine green-near-infrared fluorescence imaging showed a 100% success rate and significantly improved the detection rate of lymph nodes in esophageal squamous cell carcinoma. Seven cases with lymph node metastases were all near-infrared positive, while near-infrared-negative nodes were nonmetastatic. The technique accurately identified sentinel lymph nodes and increased the number of resected mediastinal lymph nodes, suggesting […]