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Esophagectomy

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https://www.readbyqxmd.com/read/28637063/exploring-diagnostic-and-therapeutic-implications-of-endoscopic-mucosal-resection-in-eus-staged-t2-esophageal-adenocarcinoma
#1
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/28636829/analysis-of-minimally-invasive-esophagectomy-at-a-single-veterans-affairs-medical-center
#2
Matthew D Skancke, Robert A Grossman, Gustavo Marino, Fredrick J Brody, Gregory D Trachiotis
BACKGROUND: To date, there are no published studies focusing on the benefits of minimally invasive esophagectomy (MIE) versus open esophagectomy at a Veterans Affairs Medical Center (VAMC). Our primary outcome was the incidence of esophageal malignancy in the veteran population and the postoperative morbidity following traditional and MIE for malignancy. DESIGN: Retrospective analysis of the incidence of esophageal malignancy at a Veteran Integrated Service Network (VISN) 5 VAMC reported to the VAMC Esophageal Tumor Registry between 2003 and 2016 and outcomes of the veterans who received esophagectomy for malignancy...
June 21, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28632744/comparison-between-gastrostomy-feeding-and-self-expandable-metal-stent-insertion-for-patients-with-esophageal-cancer-and-dysphagia
#3
Yang Won Min, Eun Young Jang, Ji Hey Jung, Hyuk Lee, Byung-Hoon Min, Jun Haeng Lee, Poong-Lyul Rhee, Jae J Kim
BACKGROUND: Self-expandable metal stent (SEMS) insertion and percutaneous gastrostomy (PG) feeding are commonly used for patients with esophageal cancer and dysphagia. This study aimed to compare outcomes between SEMS insertion and PG feeding for them. METHODS: We retrospectively analyzed 308 patients with esophageal cancer who underwent fully covered SEMS insertion (stent group) or PG (gastrostomy group) for dysphagia due to tumor. Patients with other causes of dysphagia, such as radiation-induced or postoperative stricture, were excluded from the study...
2017: PloS One
https://www.readbyqxmd.com/read/28631201/seven-esophageal-perforation-cases-after-aortic-replacement-stenting-for-thoracic-aortic-dissection-or-aneurysm
#4
Yoshihisa Yaguchi, Yoshimasa Kumata, Masahiro Horikawa, Takashi Kiyokawa, Tsuyoshi Inaba, Ryoji Fukushima
BACKGROUND: Esophageal perforation after aortic replacement/stenting for aortic dissection or aneurysm is a rare but severe complication. However, its cause, standard treatment, and prognosis are unclear. We analyzed the treatment and outcome retrospectively from seven cases experienced at our hospital. CASE PRESENTATION: The median age of the patients was 70 years (range, 41-86), and six of the seven cases were male. As the first treatment, aortic replacement techniques were performed in five, and thoracic endovascular aortic repair (TEVAR) procedure was performed in two...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28628563/recurrence-risk-stratification-after-preoperative-chemoradiation-of-esophageal-adenocarcinoma
#5
Mian Xi, Christopher L Hallemeier, Kenneth W Merrell, Zhongxing Liao, Mariela A Blum Murphy, Linus Ho, Wayne L Hofstetter, Reza Mehran, Jeffrey H Lee, Manoop S Bhutani, Brian Weston, Dipen M Maru, Ritsuko Komaki, Jaffer A Ajani, Steven H Lin
OBJECTIVE: To discern recurrence risk stratification and investigate its influence on postoperative surveillance in patients with esophageal adenocarcinoma (EAC) after neoadjuvant chemoradiotherapy (CRT). BACKGROUND: Reports documenting recurrence risk stratification in EAC after neoadjuvant CRT are scarce. METHODS: Between 1998 and 2014, 601 patients with EAC who underwent neoadjuvant CRT followed by esophagectomy were included for analysis...
June 16, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28628561/the-surgeon-volume-outcome-relationship-not-yet-ready-for-policy
#6
J Gregory Modrall, Rebecca M Minter, Abu Minhajuddin, Javier Eslava-Schmalbach, Girish P Joshi, Shivani Patel, Eric B Rosero
OBJECTIVE: Increasing surgeon volume may improve outcomes for index operations. We hypothesized that there may be surrogate operative experiences that yield similar outcomes for surgeons with a low-volume experience with a specific index operation, such as esophagectomy. BACKGROUND: The relationship between surgeon volume and outcomes has potential implications for credentialing of surgeons. Restrictions of privileges based on surgeon volume are only reasonable if there is no substitute for direct experience with the index operation...
June 16, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28626101/-comparison-of-short-term-outcomes-between-minimally-invasive-mckeown-esophagectomy-and-ivor-lewis-esophagectomy-for-esophageal-cancer
#7
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/28625693/long-term-functional-outcomes-after-replacement-of-the-esophagus-in-pediatric-patients-a-systematic-literature-review
#8
REVIEW
Stefano Garritano, Tomoyuki Irino, Chiara Maria Scandavini, Andrianos Tsekrekos, Lars Lundell, Ioannis Rouvelas
BACKGROUND: The indications of esophageal replacement (ER) in pediatric patients include long gap esophageal atresia (LGEA), intractable post-corrosive esophageal strictures (PCES), and some rare esophageal diseases. Various conduits and procedures are currently used worldwide with a lack of consensus regarding the ideal substitute to replace the esophagus replacement. The short-term outcomes of these advanced procedures are well known; there are few data available describing long-term functional outcomes of these patients with long life expectancy...
June 8, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28615010/internet-based-perioperative-exercise-program-in-patients-with-barrett-s-carcinoma-scheduled-for-esophagectomy-ipep-study-a-prospective-randomized-controlled-trial
#9
Daniel Pfirrmann, Suzan Tug, Oana Brosteanu, Matthias Mehdorn, Martin Busse, Peter P Grimminger, Florian Lordick, Torben Glatz, Jens Hoeppner, Hauke Lang, Perikles Simon, Ines Gockel
BACKGROUND: Patients undergoing surgery for esophageal cancer have a high risk for postoperative deterioration of lung function and pulmonary complications. This is partly due to one-lung ventilation during thoracotomy. This often accounts for prolonged stay on intensive care units, delayed postoperative reconvalescence and reduced quality of life. Socioeconomic disadvantages can result from these problems. Physical preconditioning has become a crucial leverage to optimize fitness and lung function in patients scheduled for esophagectomy, in particular during the time period of neoadjuvant therapy...
June 14, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28608015/prognostic-impact-of-change-in-the-fibrinogen-and-albumin-score-during-preoperative-treatment-in-esophageal-cancer-patients
#10
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/28607286/morbidity-analysis-in-minimally-invasive-esophagectomy-for-oesophageal-cancer-versus-conventional-over-the-last-10-years-a-single-institution-experience
#11
Misbah Khan, Muhammad Ijaz Ashraf, Aamir Ali Syed, Shahid Khattak, Namra Urooj, Anam Muzaffar
BACKGROUND: There has been an increasing inclination towards minimally invasive esophagectomies (MIEs) at our institute recently for resectable oesophageal cancer. OBJECTIVES: The purpose of the present study is to report peri-operative and long-term procedure specific outcomes of the two groups and analyse their changing pattern at our institute. METHODS: All adult patients with a diagnosis of oesophageal cancer managed at our institute from 2005 to 2015 were included in this retrospective study...
July 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28602526/resident-operative-experience-at-independent-academic-medical-centers-a-comparison-to-the-national-cohort
#12
Amit R T Joshi, Amber W Trickey, Benjamin T Jarman, Kara J Kallies, Robert Josloff, Jonathan M Dort, Ravi Kothuru
PURPOSE: Independent Academic Medical Centers (IAMCs) comprise one-third of U.S. general surgery training programs. It is unclear whether IAMCs offer qualitatively or quantitatively different operative experiences than the national cohort. We analyzed a large representative sample of IAMCs to compare operative volume and variety, with a focus on low-volume procedures. METHODS: Accreditation Council for Graduate Medical Education Program Case Reports from 27 IAMCs were collected and analyzed for 3 academic years (2012-2015)...
June 8, 2017: Journal of Surgical Education
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
#13
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/28601334/variation-in-readmission-expenditures-after-high-risk-surgery
#14
Bruce L Jacobs, Chang He, Benjamin Y Li, Alex Helfand, Naveen Krishnan, Tudor Borza, Amir A Ghaferi, Brent K Hollenbeck, Jonathan E Helm, Mariel S Lavieri, Ted A Skolarus
BACKGROUND: The Hospital Readmissions Reduction Program reduces payments to hospitals with excess readmissions for three common medical conditions and recently extended its readmission program to surgical patients. We sought to investigate readmission intensity as measured by readmission cost for high-risk surgeries and examine predictors of higher readmission costs. MATERIALS AND METHODS: We used the Healthcare Cost and Utilization Project's State Inpatient Database to perform a retrospective cohort study of patients undergoing major chest (aortic valve replacement, coronary artery bypass grafting, lung resection) and major abdominal (abdominal aortic aneurysm repair [open approach], cystectomy, esophagectomy, pancreatectomy) surgery in 2009 and 2010...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28601331/risk-factors-for-delayed-gastric-emptying-in-patients-undergoing-esophagectomy-without-pyloric-drainage
#15
Lei Zhang, Sheng-Cai Hou, Jin-Bai Miao, Hui Lee
BACKGROUND: The incidence of delayed gastric emptying (DGE) after esophagectomy is 10%-50%, which can interfere with postoperative recovery in the short-term and result in poor quality of life in the long term. Pyloric drainage is routinely performed to prevent DGE, but its role is highly controversial. The aim of this study was to report the rate of DGE after esophagectomy without pyloric drainage and to investigate its risk factors and the potential effect on recovery. MATERIALS AND METHODS: Between January 2010 and January 2015, we analyzed 285 consecutive patients who received an esophagectomy without pyloric drainage...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28588716/low-expression-of-mir-1469-predicts-disease-progression-and-unfavorable-post-surgical-clinical-outcomes-in-patients-with-esophageal-squamous-cell-cancer
#16
Jin Liu, Chuifang Wang, Xiangyan Liu, Yu Wang, Haibo Liu, Guohua Ren, Liangming Zhu, Zhigang Sun, Zhitao Chen
Recent studies have demonstrated that deregulated microRNA (miRNA/miR) expression has a profound impact on biological and pathological processes; abnormal miR-1469 expression was detected in several human malignancies. In the present study, the clinicopathological and prognostic significance of miR-1469 was assessed in 129 patients with esophageal squamous cell cancer (ESCC) who successfully underwent esophagectomy and esophagogastrostomy. Low miR-1469 expression was identified to be significantly associated with tumor invasion depth (P=0...
June 2017: Oncology Letters
https://www.readbyqxmd.com/read/28577773/esophagectomy-for-superficial-esophageal-neoplasia
#17
REVIEW
Thomas J Watson
Endoscopic therapies have become the standard of care for most cases of Barrett's esophagus with high-grade dysplasia or intramucosal adenocarcinoma. Despite a rapid and dramatic evolution in treatment paradigms, esophagectomy continues to occupy a place in the therapeutic armamentarium for superficial esophageal neoplasia. The managing physician must remain cognizant of the limitations of endoscopic approaches and consider surgical resection when they are exceeded. Esophagectomy, performed at experienced centers for appropriately selected patients with early-stage disease can be undertaken with the expectation of cure as well as low mortality, acceptable morbidity, and good long-term quality of life...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28576180/optimal-use-of-combined-modality-therapy-in-the-treatment-of-esophageal-cancer
#18
REVIEW
Talha Shaikh, Joshua E Meyer, Eric M Horwitz
Esophageal cancer is associated with a poor prognosis with 5-year survival rates of approximately 15% to 20%. Although patients with early stage disease may adequately be treated with a single modality, combined therapy typically consisting of neoadjuvant chemoradiation followed by esophagectomy is being adopted increasingly in patients with locally advanced disease. In patients who are not surgical candidates, definitive chemoradiation is the preferred treatment approach. All patients with newly diagnosed esophageal cancer should be evaluated in the multidisciplinary setting by a surgeon, radiation oncologist, and medical oncologist owing to the importance of each specialty in the management of these patients...
July 2017: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/28575244/venous-superdrained-gastric-tube-pull-up-procedure-for-hypopharyngeal-and-cervical-esophageal-reconstruction-reduces-postoperative-anastomotic-leakage-and-stricture
#19
M Fujioka, K Hayashida, K Fukui, S Ishiyama, H Saijo, K Taniguchi
Gastric pull-up is a common procedure to reconstruct the continuity of the upper digestive tract after esophageal resection. However, this technique sometimes causes postoperative anastomotic leakage or stricture, resulting from insufficient blood flow at the distal end. To overcome this problem, additional microvascular venous anastomoses were performed. The purpose of this study was to compare the outcomes of post-surgical anastomotic leakage and stricture in patients with and without additional microvascular venous superdrainage after cervical esophageal and hypopharyngeal resection and gastric tube reconstruction...
August 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28575243/predictive-value-of-nodal-maximum-standardized-uptake-value-of-pretreatment-18f-fluorodeoxyglucose-positron-emission-tomography-imaging-in-patients-with-esophageal-cancer
#20
W-K Yap, Y-C Chang, C-K Tseng, C-H Hsieh, Y-K Chao, P-J Su, M-M Hou, C-K Yang, P-C Pai, C-R Lin, C-E Hsieh, Y-Y Wu, T-M Hung
We retrospectively reviewed 102 patients with esophageal cancer (97.1% squamous cell carcinoma, 96.1% stage III) received FDG-PET staging and were treated by chemoradiotherapy with or without resection to assess whether the pretreatment [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) maximum standardized uptake value (SUVmax) of the primary tumor and metastatic lymph nodes can predict the prognosis of patients with esophageal cancer. Receiver operating characteristic analysis was performed to find the cutoff values for primary tumor SUVmax and nodal SUVmax...
August 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
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