Diseases of the Esophagus最新文献

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IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-03-03 DOI: 10.1093/dote/doaf014

Nirmala Gonsalves, John Pandolfino, David Katzka

引用次数: 0

Associations between body mass index and gastroesophageal cancer incidence and mortality: novel insights from a nationwide registry-based cohort study. 体重指数与胃食管癌发病率和死亡率之间的关系：来自全国登记队列研究的新见解

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-03-03 DOI: 10.1093/dote/doaf018

Usman Saeed, Tor Åge Myklebust, Trude Eid Robsahm, Dagfinn Aune, Bjørn Møller, Bjørn Steen Skålhegg, Sheraz Yaqub, Tom Mala

{"title":"Associations between body mass index and gastroesophageal cancer incidence and mortality: novel insights from a nationwide registry-based cohort study.","authors":"Usman Saeed, Tor Åge Myklebust, Trude Eid Robsahm, Dagfinn Aune, Bjørn Møller, Bjørn Steen Skålhegg, Sheraz Yaqub, Tom Mala","doi":"10.1093/dote/doaf018","DOIUrl":"10.1093/dote/doaf018","url":null,"abstract":"The association between body mass index (BMI) and cancers of the esophagus and the stomach remains complex and requires further exploration. This study aimed to investigate this association, including early-onset (< 50 years) cancer and cancer related mortality. A nationwide registry-based cohort study was performed by linking data from multiple national registries in Norway. The cohort included 1,723,692 individuals, with 22,473 gastroesophageal cancer cases identified over 55,701,169 person-years of follow-up. In men, a 5 kg/m2 increase in BMI was associated with an increased risk of esophageal (HR 1.34, 95%CI 1.22-1.48) and cardia adenocarcinoma (HR 1.36, 95% CI, 1.22-1.50). This finding extended to individuals with high BMI in early life (16-29 years) for esophageal adenocarcinoma. The highest risk per 5 kg/m2 increase in BMI was observed for early-onset esophageal (HR 2.49, 95%CI 1.23-5.02) and cardia adenocarcinoma (HR 2.26, 95%CI 1.19-4.27). Among women, increased BMI was associated with a higher risk of both esophageal (HR 1.28, 95%CI 1.13-1.44) and gastric adenocarcinoma (HR 1.04, 95%CI 1.01-1.07). Women with elevated BMI in early life also demonstrated increased risk for these cancers. In both sexes, a 5 kg/m2 increase in BMI was inversely associated with squamous cell carcinoma of the esophagus. No association was observed between BMI and risk of cancer-related mortality. This study highlights an elevated risk of gastroesophageal adenocarcinomas with increasing BMI, with notable sex, age, and site-specific variations. The findings also point to a heightened risk of early-onset esophageal and cardia adenocarcinoma in men with high BMI.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Treatment of intrathoracic anastomotic leakage following esophagectomy for gastroesophageal cancer: a systematic review. 胃食管癌食管切除术后胸内吻合口瘘的治疗：一项系统综述。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-03-03 DOI: 10.1093/dote/doaf016

Andreas Weise Mucha, Rune Broni Strandby, Nikolaj Albeck Nerup, Michael Patrick Achiam

{"title":"Treatment of intrathoracic anastomotic leakage following esophagectomy for gastroesophageal cancer: a systematic review.","authors":"Andreas Weise Mucha, Rune Broni Strandby, Nikolaj Albeck Nerup, Michael Patrick Achiam","doi":"10.1093/dote/doaf016","DOIUrl":"https://doi.org/10.1093/dote/doaf016","url":null,"abstract":"Anastomotic leakage (AL) is a significant complication following esophagectomy. AL affects 8%-17% of patients and is associated with increased morbidity, mortality, and hospital stay. To this date, no consensus exists on the most optimal treatment. This systematic review aimed to determine the most effective treatment approach. A systematic search of Medline, Web of Science, Cochrane, Scopus, and Embase databases was conducted. Only studies reporting on the treatment of intrathoracic anastomotic leakage after esophagectomy with gastric conduit reconstruction for cancer were included. Studies investigating other esophageal disorders or failing to report the location of the anastomosis were excluded. The methodological quality and risk of bias were assessed using the Newcastle-Ottawa Scale for cohort studies. Out of 12,966 identified studies, 38 were included for analysis after removing duplicates and screening titles, abstracts, and full texts. Of these, five were found to be of poor methodological quality and 33 were of moderate quality. The most researched treatment methods were Endoluminal vacuum therapy (EVT), naso-fistula tube drainage (NFTD), and stent treatment. The success and mortality rates for EVT were 82% and 10.7%, for NFTD, 94% and 5.2%, and, for stent treatment, 75.1% and 13.5%, respectively. AL can be effectively treated with EVT, stent treatment, and NFTD. The NFTD approach appeared to have a higher success rate and lower mortality than other treatment modalities. However, it requires a longer treatment duration. Due to limitations within the included studies, a definitive recommendation regarding the optimal treatment for AL cannot be made.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reliability of symptoms for diagnosis and sling fiber preservation for prevention of GERD after POEM: is there a problem? 症状诊断的可靠性和悬吊纤维保存预防POEM后胃反流：有问题吗？

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-03-03 DOI: 10.1093/dote/doaf015

Zaheer Nabi, D Nageshwar Reddy

引用次数: 0

Robotic- assisted minimally invasive Ivor-Lewis handsewn anastomosis technique and outcomes from a large-volume European centre. 机器人辅助微创Ivor-Lewis手缝吻合技术及欧洲大容量中心的结果。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-03-03 DOI: 10.1093/dote/doaf019

Annalisa Y L Ng, Lucas Goense, Sylvia Van De Horst, Jan Willem Van Den Berg, Jelle P Ruurda, Richard Van Hillegersberg

{"title":"Robotic- assisted minimally invasive Ivor-Lewis handsewn anastomosis technique and outcomes from a large-volume European centre.","authors":"Annalisa Y L Ng, Lucas Goense, Sylvia Van De Horst, Jan Willem Van Den Berg, Jelle P Ruurda, Richard Van Hillegersberg","doi":"10.1093/dote/doaf019","DOIUrl":"10.1093/dote/doaf019","url":null,"abstract":"In minimally invasive transthoracic esophagectomy, intrathoracic anastomoses are usually performed with stapling devices to avoid a technically challenging handsewn technique in the upper mediastinum. Few have published about handsewn anastomotic techniques due to the technically demanding requirements for suturing with rigid instruments in the thoracic cavity. With robot-assisted minimally invasive esophagectomy (RAMIE), the robot provides increased dexterity, enabling construction of a hand-sewn intrathoracic anastomosis. This study aimed to evaluate the outcomes of our technique for hand-sewn intrathoracic anastomosis in RAMIE, following the initial learning phase between 2016 and 2018 in UMC Utrecht. Patients who underwent RAMIE with a robot-assisted hand-sewn intrathoracic anastomosis were included in this retrospective study. Data were extracted from a prospectively maintained institutional database. Key technique steps included esophageal stay-sutures, use of barbed sutures for the anastomosis, placement of tension-releasing stitches, and covering of the anastomosis with omentum. The primary outcome was anastomotic leakage; secondary outcomes included anastomotic stricture rate and duration of anastomosis construction. Between 1 November 2019 and 30 May 2023, 89 consecutive patients were included. Anastomotic leakage (defined by the Esophageal Complications Consensus Group) occurred in 11 patients (12.4%), which involved a grade I leak in four patients (4.5%), grade II leak in one patient (1.1%), and grade III leakage in six patients (6.7%). The median duration of anastomosis creation was 33 minutes (range, 23-55 minutes). Stricture rate was 32.6% (29 patients) at 1 year post-operatively for which dilation was needed for all patients. This study shows that a robot-assisted hand-sewn intrathoracic anastomosis in RAMIE is feasible, safe, and reliable.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Burden of eosinophilic esophagitis in adult and adolescent patients: results from a real-world analysis. 成人和青少年患者嗜酸性粒细胞性食管炎的负担：来自现实世界分析的结果。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-03-03 DOI: 10.1093/dote/doaf024

Alain M Schoepfer, Stevie Olsen, James Siddall, Eilish McCann, Siddhesh Kamat, Kinga Borsos, Angela Khodzhayev, Amr Radwan, Tiffany Pela, Juby Jacob-Nara, Sarette T Tilton, Ryan B Thomas

{"title":"Burden of eosinophilic esophagitis in adult and adolescent patients: results from a real-world analysis.","authors":"Alain M Schoepfer, Stevie Olsen, James Siddall, Eilish McCann, Siddhesh Kamat, Kinga Borsos, Angela Khodzhayev, Amr Radwan, Tiffany Pela, Juby Jacob-Nara, Sarette T Tilton, Ryan B Thomas","doi":"10.1093/dote/doaf024","DOIUrl":"10.1093/dote/doaf024","url":null,"abstract":"Background: Real-world data on the impact of eosinophilic esophagitis (EoE) in patients are limited. This study assessed clinical characteristics, healthcare resource utilization (HCRU), symptoms, comorbidities, and quality of life (QoL) of EoE patients.Methods: The multicountry cross-sectional survey, Adelphi EoE Disease Specific Programme™, collected physician and patient-reported data on clinical characteristics, HCRU, symptoms, comorbidities, and QOL of EoE patients with past/current proton pump inhibitor use and ongoing dysphagia-related symptoms (September to December 2020) at study entry.Results: Physicians provided clinical characteristics, symptom, comorbidity, and HCRU data for 412 patients (12-17 years: 8%; ≥18 years: 92%); and 161 of these patients (12-17 years: 6%; ≥18 years: 94%) provided symptom and QOL data. Of the 412 patients, 67% were male, with a mean (SD) age of 37.0 (15.3) years. Overall, 74% of patients were currently being treated with corticosteroids (12-17 years: 88%; ≥18 years: 73%); 25% of patients had a history of esophageal dilations (12-17 years: 19%; ≥18 years: 26%); and 30% of patients had EoE-related emergency room visit (12-17 years: 31%; ≥18 years: 30%) in the last year. Among the 161 patients, heartburn (69%) was the most commonly reported symptom; the greatest negative impacts on QOL were reported for dysphagia-related anxiety, social activities involving food, and maintaining friendships (EoE Impact Questionnaire scores [1-5, low to high impact]: 1.6-2.2 for both age groups).Conclusion: EoE patients continued to experience disease burden despite receiving treatment, highlighting the high unmet need for effective disease management in this population.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Peroral plication of the esophagus as a treatment option for end-stage achalasia with sump formation. 经口食道延伸术作为终末期贲门失弛缓症伴肺泡形成的治疗选择。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-03-03 DOI: 10.1093/dote/doaf013

Ryan G Alexander, Louis M Wong Kee Song, Avinash K Nehra, Jeffrey A Alexander, Don C Codipilly, Shanda H Blackmon, Karthik Ravi

{"title":"Peroral plication of the esophagus as a treatment option for end-stage achalasia with sump formation.","authors":"Ryan G Alexander, Louis M Wong Kee Song, Avinash K Nehra, Jeffrey A Alexander, Don C Codipilly, Shanda H Blackmon, Karthik Ravi","doi":"10.1093/dote/doaf013","DOIUrl":"https://doi.org/10.1093/dote/doaf013","url":null,"abstract":"Introduction: Peroral plication of the esophagus (POPE) can reduce sump size and improve symptoms in end-stage achalasia. However, its long-term efficacy and safety are unknown.Methods: Patients with end-stage achalasia who underwent POPE at our institution (2016-2024) were identified. Data were abstracted for patient demographics, procedural details, and clinical and radiographic outcomes.Results: Twelve patients underwent POPE. The technical success rate was 100%, with mean procedural time of 57 minutes and without adverse events. Symptomatic improvement occurred in 75% of patients (mean follow-up of 15 months), while 86% had radiographic improvement in sump size. Repeat POPE in 6 (50%) patients a mean of 2.6 years after index POPE and a third POPE in four (33%) patients a mean of 3.1 years later was performed, with similar technical success rates and outcomes to the index POPE.Conclusions: POPE is a safe and repeatable long-term therapeutic option in end-stage achalasia.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Economic and treatment burden among newly diagnosed patients with erosive esophagitis in the US: a national retrospective cohort study. 美国新诊断糜烂性食管炎患者的经济和治疗负担：一项全国回顾性队列研究

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-03-03 DOI: 10.1093/dote/doaf026

N J Shaheen, D A Patel, I Abeynayake, B Bui, M Gopal, R Jacob, B Chastek, C Steiger, E D Shah

{"title":"Economic and treatment burden among newly diagnosed patients with erosive esophagitis in the US: a national retrospective cohort study.","authors":"N J Shaheen, D A Patel, I Abeynayake, B Bui, M Gopal, R Jacob, B Chastek, C Steiger, E D Shah","doi":"10.1093/dote/doaf026","DOIUrl":"https://doi.org/10.1093/dote/doaf026","url":null,"abstract":"Erosive esophagitis (EE) is a common complication of gastroesophageal reflux disease. Guidelines support long-term proton pump inhibitor (PPI) therapy to relieve symptoms and maintain healing of EE. Ideally, patients remain on their first line of therapy (LOT) with an effective PPI. We aimed to measure how often patients receive PPI, persistence and cycling among LOTs, and resulting healthcare resource utilization and costs. We assessed administrative claims data of patients diagnosed with EE between 0 October 2016 and 31 December 2020 using the Optum Research Database. We assessed prescribing rates of the first PPI, persistence, and rate of cycling among LOTs, health care resource utilization, and overall costs. Of 281,087 patients with EE, 178,789 had endoscopy. Overall, 27% of EE-diagnosed patients and 21% of patients in the endoscopy subgroup did not receive a PPI prescription. Among patients that did receive PPI, cycling and switching among PPIs was common, with over 50% of those patients switching to another PPI or back to a previously-used PPI after a lapse in therapy. Average total all-cause costs per patient among endoscopy patients (including patients with no record of PPI fills) were $58,692.46, and average total EE-related costs were $4304.88. Patients with EE frequently cycle and switch among PPIs. About one-fifth of patients who underwent endoscopy did not receive prescription PPI. Health care resource utilization and costs in patients with EE are substantial. PPI cycling and high discontinuation rates to PPI therapy contribute to costs associated with EE and potential delays in effective therapy.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Causes of death in locally advanced esophageal cancer undergoing neoadjuvant chemotherapy and neoadjuvant chemoradiotherapy: a retrospective cohort study. 局部晚期食管癌接受新辅助化疗和新辅助放化疗的死亡原因：一项回顾性队列研究。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-03-03 DOI: 10.1093/dote/doaf017

Dong Liu, Huan-Wei Liang, Yang Liu, Wei Huang, Xin-Bin Pan

{"title":"Causes of death in locally advanced esophageal cancer undergoing neoadjuvant chemotherapy and neoadjuvant chemoradiotherapy: a retrospective cohort study.","authors":"Dong Liu, Huan-Wei Liang, Yang Liu, Wei Huang, Xin-Bin Pan","doi":"10.1093/dote/doaf017","DOIUrl":"https://doi.org/10.1093/dote/doaf017","url":null,"abstract":"Purpose: To compare the causes of death in patients with locally advanced esophageal cancer treated with neoadjuvant chemotherapy versus neoadjuvant chemoradiotherapy followed by surgery.Materials and methods: A retrospective cohort study was conducted on patients with stage T3-4aN0M0/T1-4aN1-3 M0 esophageal cancer who underwent either neoadjuvant chemotherapy or neoadjuvant chemoradiotherapy followed by surgery. Overall survival (OS) and specific causes of death were analyzed and compared between the two treatment groups.Results: A total of 4528 patients were included: 333 (7.4%) received neoadjuvant chemotherapy, and 4195 (92.6%) underwent neoadjuvant chemoradiotherapy. The 5-year OS was comparable between the two groups, both before (42.4% vs. 39.7%; hazard ratio [HR] = 1.14, 95% confidence interval [CI]: 0.98-1.33; P = 0.097) and after (42.2% vs. 42.2%; HR = 1.07, 95% CI: 0.86-1.31; P = 0.567) propensity score matching. The cumulative 5-year absolute risk of death from esophageal cancer (49.9% vs. 50.6%, P = 0.470), death from non-tumor causes (7.8% vs. 9.7%, P = 0.160), death due to lung causes (2.8% vs. 1.4%, P = 0.432), and death from heart-related causes (2.2% vs. 2.0%, P = 0.524) were similar between the two treatment groups.Conclusion: In patients with locally advanced esophageal cancer, OS and the causes of death were comparable between those receiving neoadjuvant chemotherapy and those undergoing neoadjuvant chemoradiotherapy.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Letter to the editor: surgical treatment of esophago-tracheobronchial fistulas after esophagectomy. 致编辑：食管切除术后食管气管支气管瘘的手术治疗。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-03-03 DOI: 10.1093/dote/doaf002

Qingzhen Wu, Bo Ning, Enqiang Linghu

引用次数: 0