A review highlights that sentinel lymph node mapping significantly enhances metastasis detection in esophageal cancer. This technique targets lymph nodes likely to harbor metastases using various tracers, aiding surgical lymphadenectomy, increasing accuracy, and personalizing treatment. While the need for larger studies and long-term data remains, preliminary findings indicate improved staging without a notable rise in […]
Category: Upper Gastrointestinal Tract
Machine learning predicts duodenal stump leakage in gastric cancer.
A machine learning model was developed to predict duodenal stump leakage (DSL) in 1,107 gastric cancer patients post-gastrectomy. The model utilized 189 clinical features and evaluated six algorithms, with extreme gradient boosting (XGB) achieving the highest area under the receiver operating characteristic curve (AUROC) score of 0.880. Random forest followed with a score of 0.858. […]
Four distinct trajectories of postoperative recovery identified.
The study identified four postoperative quality of recovery (QoR) trajectories among 206 esophagectomy patients: poor QoR (18.4%), poor to moderate QoR (40.3%), moderate to good QoR (24.8%), and good QoR (16.5%). Key predictors of poor QoR included preoperative nutritional risk, lower QoR-15 scores, longer surgical duration, and higher postoperative pain scores during coughing. These findings […]
High postoperative complications and mortality remain in gastric volvulus surgeries.
A systematic review analyzed surgical outcomes for acute gastric volvulus due to large paraesophageal hernias, involving 15,178 patients across 171 studies. Despite advancements, 32% faced postoperative complications, 7.6% required reinterventions, and 30-day mortality reached 5.7%. The average hospital stay was 7.9 days. These concerning results underscore the need for early diagnosis and timely surgical intervention […]
Sequential injection-electrocoagulation improves hemostasis in ESD.
A randomized controlled trial involving 69 patients demonstrated that the sequential injection-electrocoagulation method significantly reduced the median time to hemostasis during endoscopic submucosal dissection (17 seconds) compared to traditional electrocoagulation (22 seconds), with p < 0.001. The experimental method also yielded higher visibility scores (3.24 vs. 2.82; p < 0.001) and reduced muscle injuries compared […]
Vagus nerve-preserving gastrectomy improves outcomes in early gastric cancer
A multicenter analysis involving 1,210 early gastric cancer patients revealed that vagus nerve-preserving gastrectomy enhances perioperative safety and postoperative quality of life. Patients experienced shorter hospital stays and fewer complications such as diarrhea and acid reflux. A validated 6-point risk assessment model, derived from key factors like tumor size and invasion depth, effectively categorized patients […]
Minimally invasive oesophagectomy reduces surgical complications
A nationwide study in Finland reveals that minimally invasive oesophagectomy (MIO) significantly lowers rates of surgical complications compared to open oesophagectomy (OO). Key findings include reductions in anastomotic leakage (10% vs. 14%), major complications (35% vs. 47%), and reoperations (18% vs. 26%). While rates of pneumonia and intra-abdominal abscesses were also lower with MIO, these […]
Conversion surgery enhances survival in advanced gastric cancer.
A systematic review and meta-analysis of 12 observational studies indicates that conversion surgery significantly improves overall survival at 1, 3, and 5 years and boosts progression-free survival at 1 and 3 years for patients with stage III-IV gastric cancer undergoing chemotherapy. Although adverse event rates were similar between groups, the findings highlight the potential of […]
Lower tumor regression grading enhances survival in gastric cancer.
A meta-analysis of 11 studies revealed that lower tumor regression grades (TRG) significantly correlate with improved disease-free survival (DFS) and overall survival (OS) in patients with locally advanced gastric cancer undergoing neoadjuvant chemotherapy. Specifically, patients with lower TRGs had a DFS hazard ratio of 0.53 and an OS hazard ratio of 0.59, indicating substantial survival […]
Transoral septotomy and Z-POEM are both effective treatments.
A multicenter study found that transoral septotomy (TS) and Z-POEM treatments for Zenker diverticulum yield similarly high success rates of 96.2%. While TS requires a shorter operative time and has fewer intraoperative complications, both methods resulted in favorable outcomes and significant symptom relief after a median follow-up of 45 to 66 months. The study contributes […]