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Cecilie Okholm, Kaare Terp Fjederholt, Frank Viborg Mortensen, Lars Bo Svendsen, Michael Patrick Achiam
OBJECTIVE: The aim of this study was to refine the optimal lymph node dissection in Western patients with adenocarcinoma of the esophagogastric junction (AEG). BACKGROUND: Lymphadenectomy is essential in addition to surgery for AEG. Asian studies continually present superior survival rates using a more extended lymphadenectomy compared with results reproduced in the West. Thus, the optimal extend of the lymphadenectomy remains unclear in Western patients. METHODS: A retrospective cohort was conducted of patients with AEG from January 1st, 2003 to December 31st, 2011...
March 2018: Surgical Oncology
Sabrina Rampado, Edoardo Savarino, Angelica Ganss, Giulia Pozza, Romeo Bardini
PURPOSE: The failure rate of laparoscopic anti-reflux surgery is approximately 10-20%. The aim of our prospective study was to investigate whether a modified Nissen fundoplication (MNF) can improve reflux symptoms and prevent surgical treatment failure in the midterm. METHODS: The MNF consisted of (1) suturing the esophagus to the diaphragmatic crura on each side using four non-absorbable stitches, (2) reinforcing clearly weak crura with a tailored Ultrapro mesh, and (3) fixing the upper stitch of the valve to the diaphragm...
March 17, 2018: Langenbeck's Archives of Surgery
Tomoki Shimizu, Junko Fujisaki, Masami Omae, Akira Yamasaki, Yusuke Horiuchi, Akiyoshi Ishiyama, Toshiyuki Yoshio, Toshiaki Hirasawa, Yorimasa Yamamoto, Tomohiro Tsuchida
BACKGROUND: In recent years, effective outcomes of endoscopic submucosal dissection (ESD) for esophagogastric junction cancer including short-segment Barrett's esophagus (SSBE) cancer have been reported. However, the efficacy of ESD for long-segment Barrett's esophagus (LSBE) cancer is unknown. AIM: To clarify the treatment outcomes of ESD for LSBE cancer versus SSBE cancer. METHODS: A total of 86 patients with 91 superficial Barrett's esophageal adenocarcinomas who underwent ESD were enrolled; of these, 68 had underlying SSBE and 18 had LSBE...
March 14, 2018: Digestion
V Ortiz, M García-Campos, E Sáez-González, P delPozo, V Garrigues
Opioids have become the most widely prescribed analgesics in Western countries. Opioid-induced bowel dysfunction is a widely known adverse effect, with constipation the most common manifestation. Most of the opioid-related effects occur in the stomach, small intestine, and colon and have been widely studied. However, the effects related to esophageal motility are less known. Recently published retrospective studies have suggested that long-term use of opioids can cause esophageal motility dysfunction, reflecting symptoms similar to motility disorders, such as achalasia and functional esophagogastric junction outflow obstruction...
February 23, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Joshua A Sloan, Ramzi Mulki, Naemat Sandhu, Solomon Samuel, Philip O Katz
GOALS: The aim of our study was to characterize jackhammer esophagus symptoms and their relationship with the distal contractile integral (DCI) and bolus transit. BACKGROUND: Jackhammer esophagus is defined by the Chicago Classification version 3.0. This diagnosis is relatively new, with the most current definition being established in 2014. The forerunners of this diagnosis, nutcracker (or hypercontractile) esophagus, have been associated with noncardiac chest pain (NCCP)...
March 7, 2018: Journal of Clinical Gastroenterology
Rodica Birla, Petre Hoara, Andrei Caragui, Marica Cristian, Silviu Constantinoiu
Adenocarcinoma of the gastroesophageal junction is more common in the West. Preoperative chemotherapy or chemoradiotherapy is performed for locally advanced disease. Recent studies are suggesting higher rates of curative resection and reduced rates of local recurrence in patients with neoadjuvant combination of chemotherapy and radiation therapy. The role of targeted agents in neoadjuvant therapy is under investigation.
January 2018: Chirurgia
Anupong Tangaroonsanti, Augustine S Lee, Marcelo F Vela, Michael D Crowell, David Erasmus, Cesar Keller, Jorge Mallea, Francisco Alvarez, Cristina Almansa, Kenneth R DeVault, Lesley A Houghton
GOALS: To assess the effect of unilateral versus bilateral lung transplantation (LTx) on esophageal motility and gastroesophageal reflux, and the association with the development of obstructive chronic lung allograft dysfunction (o-CLAD). BACKGROUND: We have shown that esophagogastric junction outflow obstruction, incomplete bolus transit, and proximal reflux are all independent risk factors for the development of chronic allograft failure. However, it remains unclear whether these factors are influenced by the type of surgery and how this relates to allograft failure...
March 2, 2018: Journal of Clinical Gastroenterology
Fenglin Liu, Xinyu Qin
Many retrospective and cohort studies have shown that laparoscopic total gastrectomy(LTG) has advantages of less trauma, quicker recovery and better incision than open total gastrectomy, and is not inferior to laparotomy in safety and the short- and long-term outcomes, so it has been widely applied. However there is still a lack of high level evidence-based basis. At present, several prospective multicenter clinical studies are being carried out in China, Japan and South Korea which have high incidence of gastric cancer to demonstrate the safety and feasibility of LTG and evaluate its long-term outcomes as well...
February 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Andrew G Nicholson, Ming S Tsao, William D Travis, Deepa T Patil, Francoise Galateau-Salle, Mirella Marino, Sanja Dacic, Mary Beth Beasley, Kelly J Butnor, Yasushi Yatabe, Harvey I Pass, Valerie W Rusch, Frank C Detterbeck, Hisao Asamura, Thomas W Rice, Ramon Rami-Porta
CONTEXT: - The Staging and Prognostic Factors Committee of the International Association for the Study of Lung Cancer, in conjunction with the International Mesothelioma Interest Group, the International Thymic Malignancy Interest Group, and the Worldwide Esophageal Cancer Collaboration, developed proposals for the 8th edition of their respective tumor, node, metastasis (TNM) staging classification systems. OBJECTIVE: - To review these changes and discuss issues for the reporting pathologist...
February 26, 2018: Archives of Pathology & Laboratory Medicine
Gerd Jomrich, Marlene Hollenstein, Maximilian John, Andreas Baierl, Matthias Paireder, Ivan Kristo, Aysegül Ilhan-Mutlu, Reza Asari, Matthias Preusser, Sebastian F Schoppmann
The modified Glasgow Prognostic Score (mGPS) combines the indicators of decreased plasma albumin and elevated CRP. In a number of malignancies, elevated mGPS is associated with poor survival. Aim of this study was to investigate the prognostic role of mGPS in patients with neoadjuvantly treated adenocarcinomas of the esophagogastric junction 256 patients from a prospective database undergoing surgical resection after neoadjuvant treatment between 2003 and 2014 were evaluated. mGPS was scored as 0, 1, or 2 based on CRP (>1...
January 23, 2018: Oncotarget
Joseph R Triggs, Peter J Kahrilas
Achalasia is currently diagnosed according to the Chicago Classification v3.0 using high-resolution manometry and treatment focuses on disruption of the esophagogastric junction. A paper in this issue examines the utility of a timed barium esophagram with a 13 mm tablet challenge in differentiating achalasia from other diagnoses, finding 100% sensitivity. However, a large proportion of patients with non-achalasia dysphagia are also identified. Another paper in this issue proposes utilizing intraprocedure functional luminal imaging probe measurement during pneumatic dilation as a guide for upsizing dilations...
February 2018: American Journal of Gastroenterology
Can Konca, Ali Abbas Yılmaz, Süleyman Utku Çelik, Selami Ilgaz Kayılıoğlu, Özge Tuğçe Paşaoğlu, Halil Arda Ceylan, Volkan Genç
BACKGROUND: Staple-line leak is the most frightening complication of laparoscopic sleeve gastrectomy and several predisposing factors such as using improper staple sizes regardless of gastric wall thickness, narrower bougie diameter and ischemia of the staple line are asserted. AIMS: The goal of this study was to evaluate the effects of different bougie diameters on tissue oxygen partial pressure at the esophagogastric junction after sleeve gastrectomy. STUDY DESIGN: The study was designed as a randomized and controlled animal experiment with 1:1:1:1 allocation ratio...
February 20, 2018: Balkan Medical Journal
Kazuyuki Tanaka, Mikihiro Fujiya, Masami Ijiri, Keitaro Takahashi, Katsuyoshi Ando, Yoshiki Nomura, Nobuhiro Ueno, Shin Kashima, Takuma Goto, Junpei Sasajima, Takahiro Ito, Kentaro Moriichi, Yusuke Mizukami, Hiroki Tanabe, Toshikatsu Okumura
No abstract text is available yet for this article.
February 19, 2018: Journal of Gastrointestinal Cancer
Yingcai Hong, Huaisheng Chen, Zhanpeng Rao, Bin Peng, Hong Hu, Shaolin Lin, Zhenglei Xu
Trastuzumab is recommended for the treatment of human epidermal growth factor receptor 2-positive adenocarcinoma of the esophagogastric junction (AEG) in combination with chemotherapy; however, drug resistance has severely affected its clinical application. The present study aimed to investigate the effect of sex determining region Y-box 9 (SOX9), a prognostic marker in adjuvant oncological settings, on AEG cell proliferation and apoptosis in the presence or absence of trastuzumab. Furthermore, the molecular mechanism underlying the role of SOX9 in trastuzumab resistance was explored...
March 2018: Experimental and Therapeutic Medicine
Emil Ter Veer, Aafke Creemers, Laura de Waal, Martijn G H van Oijen, Hanneke W M van Laarhoven
According to the ToGA study, trastuzumab plus cisplatin and capecitabine/5-fluorouracil (5-FU) is standard first-line treatment for HER2-positive advanced esophagogastric cancer. We examined the relative efficacy and safety of alternative trastuzumab-based cytotoxic backbone regimens compared to the standard ToGA regimen using meta-analysis. We searched Medline, EMBASE, CENTRAL and ASCO and ESMO up to March 2017 for studies investigating alternative first-line trastuzumab-based regimens for HER2-positive esophagogastric cancer, defined as high protein expression IHC3+ or IHC2+ and gene amplification by in-situ-hybridisation...
February 16, 2018: International Journal of Cancer. Journal International du Cancer
Yujiro Tanaka, Takahisa Tainaka, Hiroo Uchida
Total esophagogastric dissociation (TED) is used to treat gastroesophageal reflux (GER) after failed fundoplication in neurologically impaired patients. It is now performed for some otherwise healthy patients with severe GER. In this procedure, the gastrointestinal tract is reconstructed in a non-physiological way with a Roux-en-Y esophagojejunal anastomosis and jejuno-jejunostomy. Although TED eliminates almost all GER, some patients experience late complications. In this review, we investigated the long-term outcomes after TED to determine the best indications...
February 12, 2018: Surgery Today
Nilanjana Tewari, Sherif Awad, Ian A Macdonald, Dileep N Lobo
OBJECTIVE: The aim of this study was to compare the accuracy of measurements of body composition made using dual x-ray absorptiometry (DXA), analysis of computed tomography (CT) scans at the L3 vertebral level, and bioelectrical impedance analysis (BIA). METHODS: DXA, CT, and BIA were performed in 47 patients recruited from two clinical trials investigating metabolic changes associated with major abdominal surgery or neoadjuvant chemotherapy for esophagogastric cancer...
March 2018: Nutrition
Constanza Ciriza de Los Ríos, Fernando Canga Rodríguez-Valcárcel, Alicia de Pablo Gafas, Isabel Castel de Lucas, David Lora Pablos, Gregorio Castellano Tortajada
BACKGROUND: lung transplantation (LTx) is a viable option for most patients with end-stage lung diseases. Esophageal motor disorders (EMD) are frequent in candidates for LTx, but there is very little data about changes in esophageal motility post-LTx. AIM: the aim of our study was to assess esophageal motor disorders by high resolution manometry (HRM) both pre-LTx and six months post-LTx in patients with and without organ rejection. STUDY: HRM (Manoscan®) was performed in 57 patients both pre-LTx and six months post-LTx...
February 9, 2018: Revista Española de Enfermedades Digestivas
Natalia Afonso Luis, Maria Asunsión Acosta Mérida, Joaquín Marchena Gómez
A 75-year-old male who underwent an Ivor Lewis esophagectomy due to a distal adenocarcinoma had a leak at the gastroplasty on the 5th day after surgery, which required two surgeries and a primary suture. He was transferred to our hospital due to a poor outcome and endoscopy revealed a 2.5cm gap perianastomotically on the gastroplasty wall, for which a stent was placed. Due to hemodynamic impairment, a thoracotomy procedure was performed, which revealed stent protrusion into the cavity. The patient underwent an esophagogastric anastomosis resection, cervical esophagostomy and gastrostomy...
February 9, 2018: Revista Española de Enfermedades Digestivas
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