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https://www.readbyqxmd.com/read/28647071/volume-outcome-relationships-in-thoracic-surgery
#1
REVIEW
Benjamin D Kozower, George J Stukenborg
Most thoracic surgery studies indicate that hospital and surgeon procedure volume are inversely associated with mortality. However, controversy exists regarding the strength and validity of this volume-outcome association. Because thresholds of procedure volume are used to recommend the regionalization of care, investigation of the volume-outcome relationship is imperative. This article examines the methodology used in the volume-outcome relationship literature and highlights important areas of concern. Careful examination of the literature demonstrates that lung and esophageal cancer resection volume is not strongly associated with mortality and should not be used as a proxy measure for quality...
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28647070/national-quality-forum-metrics-for-thoracic-surgery
#2
REVIEW
Anthony Cipriano, William R Burfeind
The National Quality Forum (NQF) is a multistakeholder, nonprofit, membership-based organization improving health care through preferential use of valid performance measures. NQF-endorsed measures are considered the gold standard for health care measurement in the United States. The Society of Thoracic Surgeons is the steward of the only six NQF-endorsed general thoracic surgery measures. These measures include one structure measure (participation in a national general thoracic surgery database), two process measures (recording of clinical stage and recording performance status before lung and esophageal resections), and three outcome measures (risk-adjusted morbidity and mortality after lung and esophageal resections and risk-adjusted length of stay greater than 14 days after lobectomy)...
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28647068/risk-adjustment-and-performance-measurement-for-esophageal-cancer-resection
#3
REVIEW
Stephanie G Worrell, Andrew C Chang
Achieving high-quality care for all patients undergoing esophageal cancer requires identifying and modifying risk factors associated with poor outcomes. These factors occur at different time points from the preoperative to the postoperative periods. A straightforward model for predicting outcomes has proved difficult to identify. This article reviews the current studies addressing risk adjustment and performance measurement for esophageal cancer resection.
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28646334/extent-of-mediastinal-lymphadenectomy-and-survival-in-superficial-esophageal-squamous-cell-carcinoma
#4
Seong Yong Park, Dae Joon Kim, Taeil Son, Yong Chan Lee, Chang Young Lee, Jin Gu Lee, Kyung Young Chung
BACKGROUND: The aim of this study is to investigate the utility of total mediastinal lymphadenectomy (ML) in superficial esophageal squamous cell carcinoma (ESCC). METHODS: The medical records of 129 patients who underwent esophagectomy and lymph node dissection for pathologically confirmed pT1 ESCC between July 2006 and December 2014 were retrospectively reviewed. Limited ML, such as traditional 2-field or transhiatal esophagectomy, was performed in 42 patients (group 1), and total ML, including the bilateral recurrent laryngeal nerve nodes, was performed in 87 patients (group 2)...
June 23, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28644569/gastrointestinal-stromal-tumors-of-the-esophagus-a-clinicopathologic-and-molecular-analysis-of-27-cases
#5
Guhyun Kang, Yuna Kang, Kyung-Hee Kim, Sang Yun Ha, Jung Yeon Kim, Young Mog Shim, Michael C Heinrich, Kyoung-Mee Kim, Christopher L Corless
AIMS: Gastrointestinal stromal tumors (GISTs) may arise anywhere in the gastrointestinal tract, but are rare in the esophagus. We describe the clinical, pathologic, and molecular characteristics of 27 primary esophageal GISTs, the largest series to date. METHODS AND RESULTS: DNA was extracted and exons 9, 11, 13 and 17 of KIT, exons 12, 14 and 18 of PDGFRA and exon 15 of BRAF were amplified and sequenced. Esophageal GISTs occurred in 14 men and 13 women between 22 and 80 years of age (mean, 56 years)...
June 23, 2017: Histopathology
https://www.readbyqxmd.com/read/28643075/a-standardized-comparison-of-peri-operative-complications-after-minimally-invasive-esophagectomy-ivor-lewis-versus-mckeown
#6
Andrew M Brown, Michael J Pucci, Adam C Berger, Talar Tatarian, Nathaniel R Evans, Ernest L Rosato, Francesco Palazzo
BACKGROUND: While our institutional approach to esophageal resection for cancer has traditionally favored a minimally invasive (MI) 3-hole, McKeown esophagectomy (MIE 3-hole) during the last five years several factors has determined a shift in our practice with an increasing number of minimally invasive Ivor Lewis (MIE IL) resections being performed. We compared peri-operative outcomes of the two procedures, hypothesizing that MIE IL would be less morbid in the peri-operative setting compared to MIE 3-hole...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28643073/endoscopic-resection-of-giant-fibrovascular-esophageal-polyps
#7
Marc A Ward, Kristin W Beard, Ezra N Teitelbaum, Ahmed M Sharata, Christy M Dunst, Lee L Swanstrom, Kevin M Reavis
BACKGROUND: Giant fibrovascular esophageal polyps are rare benign intraluminal tumors that originate from the submucosa of the cervical esophagus [Owens et al. (JAMA 103: 838-842, 1994), Totten et al. (JAMA 25:606-622, 1953)]. Due to their indolent course, these tumors tend to reach enormous proportions before patients develop symptoms. Accurately diagnosing these tumors is difficult, as endoscopy may miss 25% of these lesions because these polyps exhibit normal intact esophageal mucosa [Levine et al...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28642830/a-rare-case-of-esophageal-adenocarcinoma-with-urinary-bladder-metastasis
#8
Heather Katz, Rahoma E Saad, Krista Denning, Toni O Pacioles
Metastatic esophageal adenocarcinoma to the urinary bladder is extremely rare. We describe a previously healthy 49-year-old female with recent diagnosis of adenocarcinoma of the gastroesophageal junction with metastatic disease to the liver. Biopsy was positive for human epidermal growth factor receptor 2 (HER2) by Fluorescence In Situ Hybridization (FISH). She received six cycles of Cisplatin, 5-Fluorouracil, and Herceptin and subsequently developed symptomatic anemia and hematuria. Cystoscopy with retroflexion was performed and she received a transurethral resection of bladder tumor with fulguration...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28637063/exploring-diagnostic-and-therapeutic-implications-of-endoscopic-mucosal-resection-in-eus-staged-t2-esophageal-adenocarcinoma
#9
Annieke W Gotink, Manon C W Spaander, Michael Doukas, Thjon J Tang, Paul Didden, Bas P L Wijnhoven, Marco J Bruno, Arjun D Koch
Background and study aims Treatment strategies for clinical (c)T2N0M0 esophageal adenocarcinoma (EAC) are subject to debate owing to the relative inaccuracy of tumor staging by endoscopic ultrasound (EUS), with profound implications in overstaged patients. We aimed to evaluate the final histological diagnosis of patients initially staged as having a cT2 tumor by EUS, and to assess the value of endoscopic reassessment by an interventional endoscopist, followed by an endoscopic resection when deemed feasible...
June 21, 2017: Endoscopy
https://www.readbyqxmd.com/read/28629642/splenic-vein-reconstruction-is-unnecessary-in-pancreatoduodenectomy-combined-with-resection-of-the-superior-mesenteric-vein-portal-vein-confluence-according-to-short-term-outcomes
#10
Haruyoshi Tanaka, Akimasa Nakao, Kenji Oshima, Kiyotsugu Iede, Yukiko Oshima, Hironobu Kobayashi, Yasunori Kimura
BACKGROUND: Superior mesenteric vein-portal vein confluence resection combined with pancreatoduodenectomy (SMPVrPD) is occasionally required for resection of pancreatic head tumors. It remains unclear whether such situations require splenic vein (SV) reconstruction for decompression of left-sided portal hypertension (LSPH). METHODS: The data from 93 of 104 patients who underwent pancreatoduodenectomy (PD) for pancreatic head malignancies were reviewed. Surgical outcomes in three groups-standard PD (control group), PD combined with vascular resection and SV preservation (SVp group), and SMPVrPD with SV resection (SVr group)-were compared...
June 16, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28626101/-comparison-of-short-term-outcomes-between-minimally-invasive-mckeown-esophagectomy-and-ivor-lewis-esophagectomy-for-esophageal-cancer
#11
Xiong Peng, Yun Chen, Abdillah Nassor Juma, Yanqing Wang, Yuan Zhou, Yang Jiao, Weixing Zhang, Wei Zhuang
To summarize the outcomes of 74 patients with minimally invasive McKeown esophagectomy (MIE-McKeown), and to discuss the short-term outcomes by comparing with Ivor-Lewis esophagectomy (ILE) procedure.
 Methods: A total of 74 patients with esophageal carcinoma underwent MIE-McKeown in Xiangya Hospital from November 2014 to July 2016 were retrospectively reviewed, and 85 patients underwent ILE procedure were selected as a control group. Perioperative and short-term outcomes were analyzed.
 Results: Compared with the ILE group, patients underwent MIE-McKeown had less blood loss, less pulmonary infection, longer resection length and more harvested lymph nodes (P<0...
May 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28616407/peroral-endoscopic-myotomy-poem-for-treating-esophageal-motility-disorders
#12
REVIEW
Ian Wong, Simon Law
Pneumatic dilatation and Heller myotomy have been thoroughly studied as the most viable treatment options for achalasia. The pendulum, however, is shifting to the minimally invasive approach. Since Inoue et al. published the experience of the first 17 cases of peroral endoscopic myotomy (POEM) in 2010, there have been at least 5,000 cases performed worldwide and the number is increasing exponentially. Experts across the globe have been extending the indications to various esophageal motility disorders, to patients of extremes of age, sigmoidal esophagus and re-operated patients...
April 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28616404/complications-following-endoscopic-submucosal-dissection-for-gastric-esophageal-and-colorectal-cancer-a-review-of-studies-based-on-nationwide-large-scale-databases
#13
REVIEW
Hiroyuki Odagiri, Hideo Yasunaga
Endoscopic submucosal dissection (ESD) is a relatively new procedure used for the treatment of early gastrointestinal cancers regardless of the lesion size and configuration, and it has gradually acquired popularity because of its minimally invasive nature. As compared to conventional endoscopic resection, ESD is a more complex procedure and requires a higher level of technical skill. Therefore, it is associated with a higher complication rate. Many previous studies that investigated the complication rates following ESD analyzed data from a limited number of specialized centers, possibly leading to an underestimation of the complication rates...
April 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28616399/management-of-strictures-after-endoscopic-submucosal-dissection-for-superficial-esophageal-cancer
#14
REVIEW
Koichiro Kawaguchi, Hiroki Kurumi, Yohei Takeda, Kazuo Yashima, Hajime Isomoto
Endoscopic resection of early esophageal cancer has a high therapeutic effect while being minimally invasive. Especially, the establishment of the endoscopic submucosal dissection (ESD) procedure has made it possible to resect large lesions in an en-bloc manner. As a result, accurate pathology evaluation became possible, and the risk of local recurrence was extremely low. On the other hand, esophageal strictures after endoscopic treatment of an extensive circumferential lesion are a potential problem. Previously, for the prevention and treatment of esophageal strictures, patients had to undergo painful endoscopic balloon dilation (EBD) many times...
April 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28616267/log-odds-of-positive-lymph-nodes-is-a-novel-prognostic-indicator-for-advanced-escc-after-surgical-resection
#15
Mingjian Yang, Hongdian Zhang, Zhao Ma, Lei Gong, Chuangui Chen, Peng Ren, Xiaobin Shang, Peng Tang, Hongjing Jiang, Zhentao Yu
BACKGROUND: To investigate the prognostic value of the log odds of positive lymph nodes (LODDS) in patients with advanced esophageal squamous cell carcinoma (ESCC) after surgical resection. METHODS: Clinical data of 260 patients with advanced ESCC undergoing surgical resection were retrospectively reviewed. Univariate and multivariate analysis were done using the chi-square test and Cox regression model. Receiver-operating-characteristic (ROC) curve was used to compare the association of pathologic nodal (pN) and LODDS with 3- or 5-year overall survival (OS)...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28611969/anastomotic-strictures-after-esophageal-atresia-repair-incidence-investigations-and-management-including-treatment-of-refractory-and-recurrent-strictures
#16
REVIEW
Renato Tambucci, Giulia Angelino, Paola De Angelis, Filippo Torroni, Tamara Caldaro, Valerio Balassone, Anna Chiara Contini, Erminia Romeo, Francesca Rea, Simona Faraci, Giovanni Federici di Abriola, Luigi Dall'Oglio
Improved surgical techniques, as well as preoperative and postoperative care, have dramatically changed survival of children with esophageal atresia (EA) over the last decades. Nowadays, we are increasingly seeing EA patients experiencing significant short- and long-term gastrointestinal morbidities. Anastomotic stricture (AS) is the most common complication following operative repair. An esophageal stricture is defined as an intrinsic luminal narrowing in a clinically symptomatic patient, but no symptoms are sensitive or specific enough to diagnose an AS...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28608015/prognostic-impact-of-change-in-the-fibrinogen-and-albumin-score-during-preoperative-treatment-in-esophageal-cancer-patients
#17
Satoru Matsuda, Hiroya Takeuchi, Hirofumi Kawakubo, Kazumasa Fukuda, Rieko Nakamura, Koichi Suda, Norihito Wada, Yuko Kitagawa
BACKGROUND: For resectable advanced esophageal cancer, a transthoracic esophagectomy following preoperative treatment is recognized as one of the standard treatments. Therefore, predictive markers which can be identified before surgery need to be established to identify patients with a poor prognosis. METHODS: We retrospectively reviewed 102 consecutive patients who underwent curative transthoracic esophagectomy following preoperative treatment in our institution between 2004 and 2013...
June 12, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28608012/the-advent-of-ultra-high-volume-thoracic-surgical-centers-in-shanghai
#18
Alan D L Sihoe, Baohui Han, Timothy Y Yang, Changqing Pan, Gening Jiang, Vincent W T Fang
BACKGROUND: A core principle in surgery is that high surgical volumes are conducive toward better outcomes. Ultra-high volume centers (UHVCs) have now emerged in thoracic surgery in China that now perform a volume of thoracic operations far greater than even traditional international centers of excellence. METHODS: In 2016, two hospitals in Shanghai performed over 10,000 major pulmonary, esophageal and mediastinal resections each. A qualitative analysis of the lessons learned in achieving such large operation volumes was undertaken...
June 12, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28601935/a-novel-systemic-immune-inflammation-index-predicts-survival-and-quality-of-life-of-patients-after-curative-resection-for-esophageal-squamous-cell-carcinoma
#19
Lu Wang, Cong Wang, Jiangfeng Wang, Xiaochen Huang, Yufeng Cheng
PURPOSE: A novel systemic immune-inflammation index (SII) based on platelet (P), neutrophil (N), and lymphocyte (L) counts has been reported to be associated with clinical outcomes in several solid tumors. We aimed to investigate its prognostic value in esophageal squamous cell carcinoma (ESCC) and the potential relationship with quality of life (QOL). METHODS: A total of 280 ESCC patients who underwent esophagectomy were enrolled. SII (SII = P × N/L) was calculated on the basis of data obtained within 1 week before surgery...
June 10, 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/28587972/salvage-photodynamic-therapy-accompanied-by-extended-lymphadenectomy-for-advanced-esophageal-carcinoma-a-case-report
#20
Takahiro Nishida, Shinsuke Takeno, Koji Nakashima, Masato Kariya, Haruhiko Inatsu, Kazuo Kitamura, Atsushi Nanashima
INTRODUCTION: Salvage surgery for locoregional failures after definitive chemoradiotherapy (dCRT) for esophageal cancer is widely practiced, but treatment options complementing it are also needed due to the high morbidity and mortality and low rate of curative resection. PRESENTATION OF CASE: A 58-year-old man with a surgical history of right upper lobectomy for lung cancer was diagnosed as having esophageal squamous cell carcinoma. Computed tomography revealed swelling of the lesser curvature lymph node, and it had invaded the stomach, the body and tail of the pancreas and the left gastric artery, splenic artery and celiac artery...
2017: International Journal of Surgery Case Reports
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