Diseases of the Esophagus最新文献

{"title":"Impact of transfer from pediatric gastroenterology to adult gastroenterology care in eosinophilic esophagitis.","authors":"Katherine F Webber, James C Slaughter, Dhyanesh A Patel, Girish Hiremath","doi":"10.1093/dote/doaf012","DOIUrl":"10.1093/dote/doaf012","url":null,"abstract":"<p><p>Given the chronic and progressive course of eosinophilic esophagitis (EoE), patients with pediatric-onset EoE will require uninterrupted gastroenterology (GI) care as they reach adulthood. Yet, the effectiveness of transferring and integrating EoE patients from pediatric GI (pGI) to adult GI (aGI) care has not been studied. To address this gap, we assessed loss to follow-up, duration from the last pGI to the first aGI encounters (clinic visit and EGD), and its impact on clinical course and medication non-adherence in EoE patients. We identified 58 EoE patients who initially received pGI care and were transferred to aGI between 2017 and 2023 within our institution's shared electronic medical record environment. Demographic, clinical, endoscopic, and histologic data were analyzed using descriptive statistics, survival analysis, Cox regression models, and paired comparisons. Loss to follow-up was 16%. The median duration from the last pGI clinic visit to the first aGI clinic visit was 299 days, and that for the last pGI EGD to the first aGI EGD was 730 days. A significantly higher odds of heartburn (McNemar P-value = 0.01) and higher medication non-adherence rates (7% vs. 26%) were noted in 49 patients who established care with the aGI. The endoscopic and histologic severity remained unchanged. In EoE patients, transferring from pGI to aGI care is associated with loss of follow-up, deterioration of symptoms, and medication non-adherence. There is a critical need to develop optimized protocols to ensure a seamless transfer of care for EoE patients.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558797","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}

{"title":"Optimal extent of left recurrent laryngeal nerve para-lymph node dissection in esophageal squamous cell carcinoma: a retrospective analysis based on cytokeratin 19 immunopositivity for micrometastasis detection.","authors":"Bin Zheng, Guanglei Huang, Taidui Zeng, Shuliang Zhang, Chun Chen","doi":"10.1093/dote/doae106","DOIUrl":"10.1093/dote/doae106","url":null,"abstract":"<p><p>No consensus has been achieved for the optimal extent of left recurrent laryngeal nerve para-lymph node dissection (LRLN-LND) for esophageal squamous cell carcinoma (ESCC). Surgeons follow different extents according to their experience, technical proficiency, and habits. Immunohistochemical (IHC) analysis is a feasible method to detect micrometastasis (MM) of lymph nodes in ESCC. We hereby explored the optimal extent of LRLN-LND by detecting the routine pathological and MM-positive rates of lymph nodes in different regions. We retrospectively reviewed patients who underwent R0 resection and LRLN-LND between September 2018 and July 2019. We divided lymph nodes into four groups based on the LRLN and cervicothoracic junction plane: (i) anterior LRLN region above the plane, (ii) posterior LRLN region above the plane, (iii) anterior LRLN region under the plane, and (iv) posterior LRLN region the plane. In total, 263 lymph nodes were collected from 52 patients. We detected MM based on cytokeratin 19 (CK19) immunopositivity in lymph nodes with negative histological detection. We calculated the positive rates of routine pathological and MM detection and analyzed the metastasis status in different regions. Lymph nodes of cervical regions (group 1 and group 2), which are always ignored due to inherent technical difficulties and poor exposure, showed higher positive rates than those in group 4; the rate in group 3 was also higher than that in group 4. Routine histological detection achieved positive rates of 8.9, 6.7, 1.6, and 0.9%, respectively. After the detection of MM by the CK19 IHC method, increased positive rates were achieved. To the best of our knowledge, only a few studies have focused on the optimal extent of LRLN-LND. Because of the high positive rates both in routine pathological detection and by CK19 IHC MM detection in this study, thorough LRLN-LND during esophagectomy for ESCC is necessary, including the cervical region and anterior nerve region adjacent to the trachea.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469995","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}

{"title":"Demographic analysis of survival trends in squamous cell carcinoma of the upper 1/3 of the esophagus: a population-based study.","authors":"Dylan Travis, Kingsley Nnawuba, Sruthi Vellanki, Samantha Robinson, Hanna Jensen, Anup Kumar Trikannad","doi":"10.1093/dote/doae111","DOIUrl":"10.1093/dote/doae111","url":null,"abstract":"<p><p>Esophageal malignancies, constituting 3% of global cancers, pose significant health challenges with poor survival rates. Squamous Cell Carcinoma (SCC) and Adenocarcinoma (AC) are predominant subtypes, with shifting incidences globally. This analysis will focus primarily on the demographics of survival trends for Squamous cell carcinoma of esophagus (SCCE). This retrospective study, utilizing the SEER database, examined demographic factors influencing survival trends in SCC of the upper esophagus. Variables included age, sex, race, income, and rurality. Statistical analyses included chi-square tests and multivariable models, specifically logistic regression and conditional inference tree models. A total of 2821 patients were included in this study. Demographic disparities were evident with race (p < 0.001), age (p = 0.002), and sex (p = 0.048) significantly impacting survival when holding other variables constant, with Non-Hispanic Black individuals exhibiting the greatest odds of mortality compared to other racial groups. Median household income (p = 0.344) and Rural-Urban Continuum (p = 0.100) were not significantly associated with improved survival rates when controlling for other demographics. Our findings align with previous research on sex-based survival disparities and racial variations in SCCE incidence and outcomes. Socioeconomic and biological factors contribute to these disparities, highlighting the need for tailored interventions and equitable healthcare access. Understanding demographic determinants in SCCE survival is crucial for personalized treatment and policy reforms to address disparities. Future research should focus on prospective, diverse cohorts to further elucidate these complex interactions and improve esophageal SCCE management and outcomes.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830263","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}

{"title":"Botulinum toxin injection of the lower esophageal sphincter to identify achalasia-variant esophagogastric junction outflow obstruction.","authors":"Chanakyaram A Reddy, Ashton Ellison, Anh D Nguyen, Eitan Podgaetz, Rhonda F Souza, Vani J A Konda, Stuart J Spechler","doi":"10.1093/dote/doae082","DOIUrl":"10.1093/dote/doae082","url":null,"abstract":"<p><p>Esophagogastric junction outflow obstruction (EGJOO) can be an achalasia variant caused by neuromuscular dysfunction of the lower esophageal sphincter (LES), or the manometric manifestation of mechanical processes that impair EGJ distensibility. Distinction among these conditions has important implications for treatment, but can be difficult. We hypothesized that response to botulinum toxin (BT) injection of the LES could be a diagnostic test for identifying achalasia-variant EGJOO likely to respond to LES muscle-directed invasive therapy. We reviewed our experience with symptomatic EGJOO patients who had BT injection of the LES. Data collected include demographics, esophageal body manometry findings, esophagram evidence of retention, and symptom response at 1-6 months after BT injection categorized as poor, partial, or good. Clinical response to any subsequent LES-directed invasive treatment (EsoFLIP dilation, pneumatic dilation, Heller myotomy, or POEM) also was recorded. Thirteen symptomatic EGJOO patients were included (mean age 55.9 ± 16.4 years; eight men, five women). Symptom response to BT injection was good in six (46%), partial in three (23%), and poor in three (23%); one was lost to follow-up. All five patients who received invasive treatment after partial or good response to BT had a partial or good response to invasive treatment. The one patient who had invasive treatment after a poor response to BT had a poor response to invasive treatment. These findings suggest that a good response to BT injection of the LES can identify an achalasia-variant form of EGJOO that will respond to LES muscle-directed invasive therapy.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382430","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}

{"title":"In memoriam of professor Alberto Peracchia.","authors":"Ermanno Ancona, Giovanni Zaninotto","doi":"10.1093/dote/doae103","DOIUrl":"https://doi.org/10.1093/dote/doae103","url":null,"abstract":"","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958772","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}

{"title":"Characteristics analyses and tumor staging proposal for primary malignant melanoma of the esophagus: a retrospective study.","authors":"Weijie Ye, Changsen Leng, Junying Chen, Zihang Mai, Nianjin Liu, Shuishen Zhang, Jianhua Fu, Qianwen Liu","doi":"10.1093/dote/doaf009","DOIUrl":"10.1093/dote/doaf009","url":null,"abstract":"<p><p>Primary malignant melanoma of the esophagus (PMME) is a malignant tumor with a poor prognosis. This study aimed to conduct survival analysis for patients with PMME and propose a staging system for PMME. Data from 179 patients were compiled for survival analysis and to propose a staging system for PMME. Survival analysis was conducted using the Kaplan-Meier method, log-rank test, and Cox proportional hazards model. The median OS of the 179 patients with PMME was 20.0 months. The 1-, 3-, and 5-year survival rates were 67.0%, 35.0%, and 17.0%. In the pooled analysis of 179 patients, significant differences in OS were observed between patients with tumors invading the lamina propria or muscularis mucosae (T1a) and deeper layers (T1b, T2, T3, T4) (P < 0.001). Significant differences in OS were observed between patients with no regional lymph node metastasis and those with one or more regional lymph node metastases (P < 0.001). PD-1 inhibitors significantly improved 3-year OS for patients with the pT1b-4 N+ stage (P = 0.020). The proposed staging system for PMME is as follows: (1) Stage I: T1aN0M0 (2) Stage II: T1b-4N0M0 and T1N1M0; Stage III: T2-4N1M0 and TxNxM1(P < 0.001). The lower T-stage and no lymph node metastasis indicated better prognosis. Surgery could be considered an effective treatment for patients with early-stage PMME. The effectiveness of surgery as a treatment for advanced-stage patients remained unclear and required further research. However, PD-1 inhibitors might improve the 3-year OS for advanced-stage patients. Furthermore, the tumor, node, metastasis staging system for PMME was proposed, and could be valuable in guiding prognostic predictions.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460766","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}

{"title":"Impact of cannabis use on presentation and treatment response in eosinophilic esophagitis.","authors":"Stephanie A Borinsky, Alexandra A Weir, Sean S LaFata, Timothy S Gee, Hannah L Thel, Brenderia A Cameron, Angela Z Xue, Akshatha Kiran, Adolfo A Ocampo, Justin McCallen, Christopher J Lee, Walker D Redd, Trevor S Barlowe, Rayan N Kaakati, Cary C Cotton, Swathi Eluri, Craig C Reed, Evan S Dellon","doi":"10.1093/dote/doae080","DOIUrl":"10.1093/dote/doae080","url":null,"abstract":"<p><p>Cannabis use is becoming increasingly common, both for recreational and medical purposes. However, there is a paucity of data regarding cannabis use in the context of eosinophilic esophagitis (EoE). We aimed to determine the impact of cannabis use on presentation and treatment response in EoE. To this end, we conducted a retrospective cohort study at a large academic medical center of newly diagnosed EoE patients age ≥ 12 years. Self-reported cannabis use status, baseline characteristics, and treatment response to topical corticosteroids and dietary therapy data were extracted. Bivariate and multivariable analyses were used to compare cannabis users and non-users at time of EoE diagnosis and to assess treatment response. Of 983 EoE patients, 80 reported using cannabis, with the majority reporting daily use and administration by inhalation. Baseline symptoms and peak eosinophil count were similar between cannabis users and non-users; cannabis users were less likely to have baseline endoscopic findings of exudates, edema, and stricture, and lower total Endoscopic Reference Score. On multivariable analysis, younger age, male sex, non-White race, and psychiatric diagnosis were independently associated with history of cannabis use at EoE presentation and stricture was independently associated with cannabis non-use. Post-treatment symptom and histologic responses were similar between cannabis users and non-users though there was a higher odds of post-treatment endoscopic inflammatory features with cannabis use. In conclusion, despite presenting with milder initial endoscopic findings, cannabis users exhibited greater inflammatory findings after treatment, highlighting a potential negative influence of cannabis use on EoE management.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373575","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}

{"title":"HMB/Arg/Gln may improve short-term outcomes after esophagectomy in patients with thoracic esophageal cancer.","authors":"Katsushi Takebayashi, Sachiko Kaida, Reiko Otake, Asuka Fukuo, Toru Miyake, Masatsugu Kojima, Soichiro Tani, Hiromitsu Maehira, Haruki Mori, Hajime Ishikawa, Masaji Tani","doi":"10.1093/dote/doae121","DOIUrl":"10.1093/dote/doae121","url":null,"abstract":"<p><strong>Background: </strong>The wound healing effects of a specialized amino acid supplement containing calcium beta-hydroxy-beta-methylbutyrate, L-arginine, and L-glutamine (HMB/Arg/Gln) have been reported. This study aimed to investigate the effectiveness of HMB/Arg/Gln in the perioperative management of patients with thoracic esophageal cancer.</p><p><strong>Methods: </strong>This retrospective cohort study included 131 patients who underwent esophagectomy for thoracic esophageal cancer between January 2016 and November 2023. Postoperative infectious complications (PICs) were compared between patients who received HMB/Arg/Gln for 7 days before surgery (n = 95) and those who did not (control group, n = 36).</p><p><strong>Results: </strong>Among the 111 male and 20 female patients (median age 68 years, range 38-84 years), stage I disease was found in 37 patients, stage II in 26, stage III in 61, and stage IVa in 7. Of the 131 patients, 36 (27.5%) had PICs, with PICs occurring in 20 (21%) of the HMB/Arg/Gln group and 16 (44.4%) of the control group. The PIC rate was significantly lower in the HMB/Arg/Gln than in the control group (p = 0.007). Propensity score matching analysis showed lower rates of anastomotic leakage (5.5% vs. 22.2%; p = 0.04) and Clavien-Dindo grade III or higher PICs (5.5% vs. 27.8%; p = 0.011) in the HMB/Arg/Gln than in the control group. The healing time for anastomotic leakage was shorter in the HMB/Arg/Gln (18 days, range 7-25 days) than in the control group (25 days, range 21-56 days) (p = 0.033).</p><p><strong>Conclusions: </strong>HMB/Arg/Gln supplementation was associated with reduced risk of anastomotic leakage and PIC severity following esophagectomy.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958771","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}

{"title":"Modified reconstruction procedure in subtotal esophagectomy with retrosternal gastric pull up to reduce anastomotic leakage: a propensity score-matched analysis.","authors":"Tomoyuki Okumura, Takeshi Miwa, Kenta Murotani, Yoshihisa Numata, Toru Watanabe, Isaya Hashimoto, Koki Kamiyama, Kenichi Tazawa, Fuminori Yamagishi, Tsutomu Fujii","doi":"10.1093/dote/doae100","DOIUrl":"10.1093/dote/doae100","url":null,"abstract":"<p><p>One risk factor for anastomotic leakage (AL) after esophagectomy with retrosternal gastric reconstruction is excessive compression of the gastric tube at the thoracic inlet. In this study, we evaluated the effect of our modified procedure to reduce AL by placing the esophagogastric anastomosis below the thoracic inlet. Between January 2008 and December 2022, 174 consecutive patients underwent subtotal esophagectomy with retrosternal gastric pull up, followed by circular stapler anastomosis in our hospitals. After January 2016, the gastric tube was pulled down to place the anastomosis below the suprasternal notch. Postoperative CT then measured the level of esophagogastric anastomosis (LEA). Comparing cases before and after revision (conventional group, n = 65 vs. test group, n = 109), AL was significantly reduced from 11 (16.9%) to 3 (2.8%) cases (P = 0.002). After propensity score matching, AL was observed in 14% (8/57) and 0% (0/57) cases in the conventional and test groups, respectively (P = 0.006). Smaller circular stapler size (P < 0.001), less intraoperative blood loss (P < 0.001), and lower LEA (P < 0.001) were observed in the test group than in the conventional group. Multivariate analysis revealed that anastomotic procedure (OR [95%CI], 0.01[0.00-0.46], P = 0.008), and body mass index (OR [95%CI], 6.92[1.10-135.01], P = 0.038) were the independent risk factors for the development of AL. Our modified procedure to avoid compression of the gastric tube at the thoracic inlet is suggested to noninvasively reduce the risk of AL in the subtotal esophagectomy with retrosternal reconstruction.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632461","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}

{"title":"Risk factors for readmission following esophagectomy and gastrectomy for cancer.","authors":"J F M Geerts, I van den Berg, A M J van Nistelrooij, S M Lagarde, B P L Wijnhoven","doi":"10.1093/dote/doae101","DOIUrl":"10.1093/dote/doae101","url":null,"abstract":"<p><strong>Introduction: </strong>Hospital readmission after surgery is a key quality indicator. This nationwide cohort study aimed to assess readmission rates following esophagectomy and gastrectomy for cancer and identify associated risk factors.</p><p><strong>Methods: </strong>Data were extracted from the Dutch Upper GI Cancer Audit (DUCA) for patients with esophagogastric cancer who underwent esophagectomy or gastrectomy with curative intent between January 2011 and June 2016. Logistic regression analysis identified risk factors for 30-day readmission.</p><p><strong>Results: </strong>In total, 5566 patients were included. Readmission within 30 days occurred in 483 of 3488 (13.8%) patients after esophagectomy and 243 of 2078 patients (11.7%) after gastrectomy. Both minor (Clavien Dindo 1-2) and major (Clavien Dindo ≥3) postoperative complications were independent predictors of readmission after esophagectomy (OR 2.99; 95%CI 2.23-4.02; p < 0.001 and OR 5.20; 95%CI 3.82-7.09; p < 0.001). Specific complications included pulmonary (OR 1.49; 95%CI 1.20-1.85; p < 0.001), gastrointestinal (OR 2.43; 95%CI 1.94-3.05; p < 0.001), and infectious (OR 2.27; 95%CI 1.60-3.22; p < 0.001). Prolonged length of stay (pLOS) was associated with higher readmission rates in patients without complications following esophagectomy (OR 1.91 95% CI 1.19-3.07; p = 0.008), but lower rates in those with complications (OR 0.65 95% CI 0.51-0.83; p < 0.001). For gastrectomy, postoperative complications were also linked to readmission (OR 3.18; 95%CI 2.30-4.40; p < 0.001), particularly gastrointestinal (OR 2.16; 95%CI 1.40-3.32; p < 0.001), and infectious (OR 3.80; 95%CI 2.53-5.71; p < 0.001).</p><p><strong>Conclusion: </strong>Readmission after esophagogastric resection is common, particularly among patients with both minor and major postoperative complications. Prolonged stay after esophagectomy impacts readmission risk differently based on the presence of complications.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644712","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}