Intermediate term results of a single institution experience with POEM for management of achalasia are reported for the first 100 cases. Most patients were women (59%) and the overall mean age was 48 years. POEM was successfully completed in 94 pts and without complications. Clinical success was declared in 94.5%, although pH studies documented ab
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Esophagus
December 23, 2015
December 23, 2015
This longitudinal review of single institution experience with GEJ adenocarcinomas identified time-related trends. The proportion of GEJ tumors compared to all esophageal cancers increased from 22% to 36%. GERD increased from 7% to 11%. An increased in GERD was associated with an increased in the prevalance of Seiwert I tumors. There was a signi
May 21, 2015
This prospective observational study followed 111 patients for 3 years after laparoscopic repair of a type III paraesophageal hernia. QOL improved at all postoperative time intervals from 28.5 preop to about 10. The radiographic recurrence rate was 27% at 1 year. Hernias involving most of the stomach were more likely to recur than smaller hernias.
May 17, 2015
In this population-based cohort study with 1044 patients who underwent esophagectomy for esophageal cancer between 1987 and 2010 in Sweden, the researchers found that a higher number of lymph nodes removed did not affect mortality in any specific stage.
January 10, 2015
This study investigated repair methods for large hiatal hernias randomized to suture only vs absorbable mesh vs nonabsorbable mesh. The design was randomized, double blind. At 12 mos the recurrence rate was 21%, with no difference among the groups. Postoperative symptoms were different among the groups, but these differences were judged to be of s
November 16, 2014
This article systematically reviewed the impact of surgical adverse events (SAEs) on quality of life after major GI surgery. The mean difference in QOL between pts with and without SAEs was highest for esophagectomy (0.14; scale 0 to 1), while results for antireflux surgery were mixed.
November 5, 2014
Long-term QOL outcomes were assessed in a single institution cohort of 63 patients undergoing colon interposition after esophagectomy. 48% of pts had a vagal sparing operation, and resection was performed for cancer in the majority of the pts. Followup median was 13 yrs. Mean SF36 scores were above the published average and GI QOL was 3 out of 4.
August 9, 2014
This randomized trial involving 30 centers in France compared outcomes after induction chemoradiotherapy followed by resection to resection alone for stage I or II esophageal cancer. The R0 resection rate was similar between the groups. Postoperative mortality was higher in the induction therapy group (11.1% vs 3.4%). Long-term survival was simila
July 28, 2014
The efficacy of induction therapy for clinical T2 esophageal cancer was evaluated using the National Cancer Database. Pretreatment staging was accurate in only 27% of pts. 42% of pts were upstaged and 32% were downstaged. Induction therapy had no survival benefit.
June 5, 2014
This article describes a simplified Collis gastroplasty technique performed via left chest, which negates the need for wedge fundectomy. This technique potentially saves OR time and cost, while hypothetically reducing morbidity.