Diseases of the Esophagus最新文献_第9页

Prevalence and predictors of Barrett's esophagus and esophageal cancer in patients with eosinophilic esophagitis. 嗜酸性食管炎患者Barrett食管和食管癌的患病率及预测因素。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-01-07 DOI: 10.1093/dote/doae120

Margaret J Zhou, Ann W Hsing, John O Clarke

{"title":"Prevalence and predictors of Barrett's esophagus and esophageal cancer in patients with eosinophilic esophagitis.","authors":"Margaret J Zhou, Ann W Hsing, John O Clarke","doi":"10.1093/dote/doae120","DOIUrl":"https://doi.org/10.1093/dote/doae120","url":null,"abstract":"Data on Barrett's esophagus (BE) and esophageal cancer (EC) outcomes in patients with eosinophilic esophagitis (EoE) are limited. We aimed to determine the risk of prevalent BE (<1 year after endoscopy), incident BE (≥1 year after endoscopy), and incident EC in patients with versus without EoE, and to identify predictors of BE/EC in EoE patients. We identified adult patients in the Merative MarketScan Database who underwent first-time upper endoscopy between 2008 and 2020. Chi-square analysis compared proportions of patients with versus without EoE who had BE or EC. Multivariate Cox regression determined associations between demographics/comorbidities and incident BE/EC in the EoE cohort, adjusting for established BE risk factors. Among 2,947,003 patients who underwent upper endoscopy, 20,588 patients (0.70%) had EoE (mean age 40.6 years, 63.8% male, gastroesophageal reflux disease in 44.9%). Prevalent BE, incident BE, and incident EC was found in 1.03%, 0.57%, and 0.06% of patients with EoE versus 1.06%, 0.54%, and 0.05% of patients without EoE, respectively (P = 0.13, 0.21, and 0.36, respectively). Among individuals with EoE, older age, male sex, presence of a hiatal hernia, gastroesophageal reflux disease, and location in North Central or Southern USA were independently associated with incident BE. Older age and prevalent BE were independently associated with incident EC. BE/EC risk in EoE is comparable to that of the baseline population undergoing upper endoscopy. Our findings support current understanding that EoE is not associated with an increased risk of BE/EC and reinforce that conventional BE screening strategies can be applied in patients with EoE.","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":"142958775","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

Sling fiber preservation during POEM reduces incidence of postoperative reflux symptoms. 在 POEM 期间保留吊带纤维可降低术后反流症状的发生率。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-01-07 DOI: 10.1093/dote/doae097

Yusuke Fujiyoshi, Mary Raina Angeli Fujiyoshi, Kareem Khalaf, Gary R May, Christopher W Teshima

{"title":"Sling fiber preservation during POEM reduces incidence of postoperative reflux symptoms.","authors":"Yusuke Fujiyoshi, Mary Raina Angeli Fujiyoshi, Kareem Khalaf, Gary R May, Christopher W Teshima","doi":"10.1093/dote/doae097","DOIUrl":"10.1093/dote/doae097","url":null,"abstract":"Gastroesophageal reflux disease (GERD) after peroral endoscopic myotomy (POEM) has been a limiting factor with POEM. Sling-fiber preservation during POEM was reported to reduce postoperative GERD in Japan. This study investigates the efficacy of this technique in a western population. This is a retrospective, single-center study of patients undergoing POEM from October 2017 to January 2023. The initial cohort of patients were treated by conventional POEM, after which a second cohort underwent POEM with sling-fiber preservation. The primary outcome was the incidence of postoperative reflux symptoms. The secondary outcomes were clinical success rate (Eckardt score ≤ 3), procedure time, and adverse events rate. Multivariate regression was then performed to identify factors associated with the incidence of postoperative reflux symptoms. One hundred and forty eight POEM cases (52.5 ± 15.6 y/o, female: 61[43%]) were included. The mean procedure time (108.6 ± 34.5 vs. 109.1 ± 45.7 min, P = 0.93) was similar between the groups. In the sling-fiber preservation group, gastric myotomy length was significantly longer (2.2 ± 0.7 vs. 1.6 ± 0.8 cm, P < 0.05), yet the incidence rate of postoperative reflux symptoms at follow-up was significantly lower (22.4% vs. 42.3%, P < 0.05). The clinical success rate was similar between groups (89.5% vs. 83.1%, P = 0.32), and the rate of adverse events requiring intervention (13.5% vs. 12.2%, P = 0.36) was similar. Regression analysis indicated that, after adjusting for other risk factors of postoperative GERD, sling-fiber preservation during POEM had an odds ratio of 0.24 (95% CI: 0.07-0.85, P < 0.05) for the incidence of reflux symptoms. Sling-fiber preservation during POEM reduces the incidence of postoperative reflux symptoms. As such, sling-fiber preservation may be a useful solution to reduce post-POEM GERD in western populations.","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":"142717637","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

Incidental downstream resource utilization due to endoscopic screening for Barrett's esophagus. 巴雷特食管内镜筛查引起的偶然下游资源利用。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-01-07 DOI: 10.1093/dote/doaf021

Matthew Harbrecht, Maria E Arasim, Yue Liu, Joel H Rubenstein

{"title":"Incidental downstream resource utilization due to endoscopic screening for Barrett's esophagus.","authors":"Matthew Harbrecht, Maria E Arasim, Yue Liu, Joel H Rubenstein","doi":"10.1093/dote/doaf021","DOIUrl":"10.1093/dote/doaf021","url":null,"abstract":" Cost-effectiveness analyses have demonstrated benefit in screening for Barrett's esophagus (BE) but have not included resource utilization due to incidental findings. We abstracted longitudinal data from a study of male patients aged 50-79 years undergoing research esophagogastroduodenoscopy (EGD) for BE screening regardless of symptoms. Patients were enrolled at the time colonoscopy for colorectal cancer screening at two facilities. Costs were estimated from Centers for Medicare and Medicaid Services median national reimbursements and average wholesale prices of medications. Of 822 men enrolled, almost one-third of patients had gastric biopsies obtained (32.4%) and an additional 15.7% were recommended acid suppression. Repeat EGD was recommended in only 2.0% of patients, but was the second most costly weighted resource. The total additional expected cost due to incidental findings was $66 per EGD. We conclude that incidental findings during EGD for BE leads to a modest increase in resource utilization, primarily due to biopsies and acid suppression, which should be considered in future cost-effectiveness analyses.","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755988","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

Exploring X: barriers to care for eosinophilic esophagitis. 探索 X：嗜酸性粒细胞食管炎的护理障碍。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-01-07 DOI: 10.1093/dote/doae043

Shivani U Thanawala, Ari Klein, Krish Raval, Jesus Ivan Flores Amaro, Claire A Beveridge, Amanda B Muir, Gary W Falk, Graciela Gonzalez-Hernandez, Kristle L Lynch

{"title":"Exploring X: barriers to care for eosinophilic esophagitis.","authors":"Shivani U Thanawala, Ari Klein, Krish Raval, Jesus Ivan Flores Amaro, Claire A Beveridge, Amanda B Muir, Gary W Falk, Graciela Gonzalez-Hernandez, Kristle L Lynch","doi":"10.1093/dote/doae043","DOIUrl":"10.1093/dote/doae043","url":null,"abstract":"Patients with chronic diseases have increasingly turned to social media to discuss symptoms and share the challenges they face with disease management. The primary aim of this study is to use naturally occurring data from X (formerly known as Twitter) to identify barriers to care faced by individuals affected by eosinophilic esophagitis (EoE). For this qualitative study, the X application programming interface with academic research access was used to search for posts that referenced EoE between 1 January 2019 and 10 August 2022. The posts were identified as being either related to barriers to care for EoE or not. Those related to barriers to care were further categorized by the type of barrier that was expressed. A total of 8636 EoE-related posts were annotated of which 12.1% were related to barriers to care in EoE. The themes that emerged about barriers to care included: dietary challenges, limited treatment options, lack of community support, lack of physician awareness of disease, misinformation, cost of care, lack of patient belief in disease or trust in physician, and limited access to care. Saturation of themes was achieved. This study highlights barriers to care in EoE using readily accessible social media data that is not derived from a curated research setting. Identifying these obstacles is key to improving care for this chronic disease.","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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923931","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

Clinical mechanism of muscle mass loss during neoadjuvant chemotherapy in older patients with esophageal cancer: a prospective cohort study. 老年食管癌患者在新辅助化疗期间肌肉质量下降的临床机制：一项前瞻性队列研究。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-01-07 DOI: 10.1093/dote/doae096

Tsuyoshi Harada, Tetsuya Tsuji, Junya Ueno, Nobuko Konishi, Takumi Yanagisawa, Nanako HIjikata, Aiko Ishikawa, Kakeru Hashimoto, Hitoshi Kagaya, Noriatsu Tatematsu, Sadamoto Zenda, Daisuke Kotani, Takashi Kojima, Takeo Fujita

{"title":"Clinical mechanism of muscle mass loss during neoadjuvant chemotherapy in older patients with esophageal cancer: a prospective cohort study.","authors":"Tsuyoshi Harada, Tetsuya Tsuji, Junya Ueno, Nobuko Konishi, Takumi Yanagisawa, Nanako HIjikata, Aiko Ishikawa, Kakeru Hashimoto, Hitoshi Kagaya, Noriatsu Tatematsu, Sadamoto Zenda, Daisuke Kotani, Takashi Kojima, Takeo Fujita","doi":"10.1093/dote/doae096","DOIUrl":"10.1093/dote/doae096","url":null,"abstract":"In older patients with locally advanced esophageal cancer (LAEC), loss of skeletal muscle mass during neoadjuvant chemotherapy (NAC) is associated with poor clinical outcomes. This study aimed to investigate factors associated with loss of skeletal muscle mass during NAC in older patients with LAEC. This was a single-center exploratory prospective cohort study. Consecutive patients aged ≥65 years with LAEC scheduled for curative esophagectomy after NAC were enrolled between October 2021 and December 2023. As a primary endpoint, loss of skeletal muscle mass index (ΔSMI: pre-NAC minus post-NAC value) was calculated from computed tomography images before and after NAC. Significant pre-NAC and during-NAC factors with ΔSMI were detected with a multivariate regression model. Statistical significance was considered as two-tailed P <0.05. A total of 69 patients were analyzed. The mean age was 72.9 years, and 53 (77%) were male. Mean SMI before and after NAC was 43.1 and 40.9 cm2/m2, and mean ΔSMI was 2.2 cm2/m2. In multivariate analysis, ΔSMI was associated with increased sitting time during NAC (per 1 min/day, adjusted coefficient 0.007, 95% confidence interval [CI] 0.001 to 0.013, P = 0.016), decreased Geriatric Nutritional Risk Index during NAC (per 1 score, adjusted coefficient -0.146, 95% CI -0.213 to -0.013, P = 0.002), and worsening decreased appetite during NAC (vs. no worsening, adjusted coefficient 1.571, 95% CI 0.279 to 2.862, P = 0.018). It was hypothesized that the inactivity-related mechanism and malnutrition-related mechanism are important for skeletal muscle mass loss during NAC in older patients with LAEC.","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":"142585350","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

Central ligation or partial preservation of the right gastric artery does not seem to affect conduit or anastomotic perfusion during robot-assisted resection of gastroesophageal junction cancer: a randomized clinical trial. 胃食管连接部癌机器人辅助切除术中，胃右动脉的中央结扎或部分保留似乎不会影响导管或吻合口的灌注：一项随机临床试验。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-01-07 DOI: 10.1093/dote/doae102

Jens Thomas Fredrik Osterkamp, Nikolaj Nerup, Morten Bo S Svendsen, Rune B Strandby, Lars Bo Svendsen, Eske K Aasvang, Henrik Vad, Astrid Plamboeck, Michael P Achiam

{"title":"Central ligation or partial preservation of the right gastric artery does not seem to affect conduit or anastomotic perfusion during robot-assisted resection of gastroesophageal junction cancer: a randomized clinical trial.","authors":"Jens Thomas Fredrik Osterkamp, Nikolaj Nerup, Morten Bo S Svendsen, Rune B Strandby, Lars Bo Svendsen, Eske K Aasvang, Henrik Vad, Astrid Plamboeck, Michael P Achiam","doi":"10.1093/dote/doae102","DOIUrl":"10.1093/dote/doae102","url":null,"abstract":"The gastric conduit can be created with partial preservation or a central ligation of the right gastric artery. Central ligation may facilitate complete removal of lymph node (LN) station 3; however, whether this influences conduit and anastomotic perfusion is unknown. Hence this study investigated whether a central ligation of the right gastric artery would affect conduit or anastomotic perfusion compared with partial preservation (local standard) during robot-assisted resection of gastroesophageal junction cancer. Patients scheduled for robot-assisted resection of gastroesophageal junction cancer were randomized to either central ligation or partial preservation of the right gastric artery. Perfusion was assessed using quantified indocyanine green angiography: before gastric mobilization, after conduit formation, and after anastomosis. Hemodynamic variables during surgery and surgical outcomes were recorded. We included 70 patients between June 2020 and October 2021, of whom 5 were excluded from the final analysis. The two patient groups did not differ in conduit (0.07 [interquartile range (IQR), 0.05-0.08] vs. 0.07 u [IQR, 0.05-0.08], P = 0.86) or anastomotic perfusion (0.08 [standard deviation (SD), ±0.02] vs. 0.08 u [SD, ±0.02], P = 0.21), nor did they differ in intraoperative blood loss, anastomotic leaks, postoperative complications, or 1-year survival. However, more LNs were resected in the central ligation group (36 [IQR, 30-44] vs. 28 [IQR, 23-43], P = 0.02). Introducing a central ligation of the right gastric artery did not seem to affect conduit or anastomotic perfusion, compared with partial preservation. However, significantly more LNs were resected.","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":"142669669","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

Effect of benralizumab on histopathology and inflammatory signatures in a clinical cohort of eosinophilic esophagitis. 苯拉利珠单抗对嗜酸性粒细胞食管炎临床队列中组织病理学和炎症特征的影响

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-01-07 DOI: 10.1093/dote/doae031

Ashley L Pyne, Amiko M Uchida, Mark W Hazel, Chris J Stubben, Joy W Chang, Dominique D Bailey, Nirmala Gonsalves, Kristina Allen-Brady, Kathryn A Peterson, Maria A Pletneva

{"title":"Effect of benralizumab on histopathology and inflammatory signatures in a clinical cohort of eosinophilic esophagitis.","authors":"Ashley L Pyne, Amiko M Uchida, Mark W Hazel, Chris J Stubben, Joy W Chang, Dominique D Bailey, Nirmala Gonsalves, Kristina Allen-Brady, Kathryn A Peterson, Maria A Pletneva","doi":"10.1093/dote/doae031","DOIUrl":"10.1093/dote/doae031","url":null,"abstract":"A preliminary report from the recent phase 3 trial of benralizumab, a monoclonal antibody that binds to interleukin-5 receptor alpha (IL5Rα), in patients with EoE revealed that medication use led to tissue eosinophil eradication but did not meet the clinical endpoint of symptom resolution. Here, we characterized the clinical, endoscopic, histologic, and transcriptional changes in patients with active EoE following benralizumab treatment. We retrospectively examined patients with EoE treated with benralizumab at the University of Utah (n = 11) and reviewed reported clinical symptoms, circulating and tissue eosinophilia, and endoscopic and histologic scores. Gene expression profiles from available esophageal tissue from benralizumab-treated patients were compared to those from patients with remission EoE (n = 5), active EoE (n = 10), and controls (n = 22). Benralizumab treatment resulted in partial symptom improvement and significant reduction in tissue eosinophilia, and endoscopic and histologic disease scoring (P < 0.01). Histologic score reductions were driven by eosinophil feature scores, while scores for epithelial features (basal cell hyperplasia and dilated intercellular spaces) were similar to those in active EoE. The gene signatures in benralizumab-treated patients mimicked those of active EoE (e.g. upregulation of POSTN, CDH26, CCL26, and downregulation of DSG1). RNA profiles and pathways support histologic findings of impaired epithelial function that persists despite benralizumab treatment. In conclusion, despite eosinophil eradication, patients treated with benralizumab had persistent epithelial injury at the histologic and transcriptional level. In this cohort, benralizumab therapy failed to eradicate inflammation and epithelial dysfunction showing that interleukin-5 receptor alpha blockade monotherapy is insufficient to control EoE.","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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581511","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

Association of treatment methods and survival in esophageal neuroendocrine carcinoma population of Surveillance, Epidemiology, and End Results database: a retrospective cohort study. 食道神经内分泌癌监测、流行病学和最终结果数据库中治疗方法与生存率的关系：一项回顾性队列研究。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-01-07 DOI: 10.1093/dote/doaf008

T Yang, P Yang, H Li, M Sun, J Zhang, Y Li, B Zhu

{"title":"Association of treatment methods and survival in esophageal neuroendocrine carcinoma population of Surveillance, Epidemiology, and End Results database: a retrospective cohort study.","authors":"T Yang, P Yang, H Li, M Sun, J Zhang, Y Li, B Zhu","doi":"10.1093/dote/doaf008","DOIUrl":"10.1093/dote/doaf008","url":null,"abstract":"Esophageal neuroendocrine carcinoma (ENEC) is an uncommon and highly aggressive tumor with an obscure etiology. Thus, this study aimed to investigate the best treatment option for patients with ENEC. This study identified patients with ENEC from the Surveillance, Epidemiology, and End Results (SEER) database between 1975 and 2021. Clinicopathological characteristics were analyzed using descriptive statistics, and prognostic factors were determined through Cox regression analysis. Kaplan-Meier survival analysis was used to assess five-year overall survival (OS). Patients were divided into a combined radiotherapy and chemotherapy group and a surgery group based on treatment modality. Propensity score matching (PSM) was performed to balance baseline characteristics between the two groups. A total of 604 participants were included; univariate and multivariate analyses indicated that ENEC patients with localized or regional disease had significantly higher survival rates (HR = 0.38, 95% CI 0.29-0.51, P < 0.001 and HR = 0.56, 95% CI 0.44-0.71, P < 0.001) than those with distant metastases. The combination of radiotherapy and chemotherapy (HR = 0.34, 95% CI 0.25-0.46, P < 0.001) and surgical treatment (HR = 0.43, 95% CI 0.31-0.59, P < 0.001) significantly improved survival. Kaplan-Meier analysis showed significant differences in OS among treatments (P < 0.0001), with the combination therapy and surgery groups having similar rates of 7.04% and 8.77%, respectively, and outperforming other methods. The combination therapy group maintained the best survival rate over time. The synergistic application of radiotherapy and chemotherapy has markedly enhanced the five-year survival rate of patients with ENEC, offering invaluable insights for clinical management strategies.","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":"143416195","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

Feasibility and safety of interventional radiology-guided biopsy for esophageal stenosis. 介入放射引导下食管狭窄活检的可行性和安全性。

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-01-07 DOI: 10.1093/dote/doaf005

Gang Zhou, Xiaolong Ding, Meng Wang, Yalin Tong, Yaozhen Ma, Meipan Yin, Chunxia Li, Gang Wu

{"title":"Feasibility and safety of interventional radiology-guided biopsy for esophageal stenosis.","authors":"Gang Zhou, Xiaolong Ding, Meng Wang, Yalin Tong, Yaozhen Ma, Meipan Yin, Chunxia Li, Gang Wu","doi":"10.1093/dote/doaf005","DOIUrl":"10.1093/dote/doaf005","url":null,"abstract":"Background: Endoscopic clamp biopsy is generally performed to confirm the pathological diagnosis of esophageal stenosis. However, it might be challenging in patients with severe esophageal stenosis. Hence, we aimed to investigate the feasibility and safety of interventional radiology-guided clamp biopsy under fluoroscopy for diagnosing esophageal stenosis.Methods: The clinical data of 81 patients aged 39-89 (mean age 67.4 ± 10.5) years with esophageal stenosis whose pathological tissues were obtained by interventional radiology-guided forceps biopsy at our treatment center were retrospectively analyzed; 35.8% (29/81) patients had esophageal space-occupying stenosis and 64.2% (52/81) had esophagogastric anastomotic stenosis. The detection rate of esophageal stenosis, and operation-related complications were analyzed.Results: About 75.3% (61/81) patients could not tolerate or refused endoscopic examination; the remaining 24.7% (20/81) underwent endoscopic examination, but their pathological specimens could not be obtained through the stenosis segment. The technical success rate of interventional radiology-guided clamp biopsy was 100%, and the mean duration of operation was 7.8 ± 4.2 minutes. No serious operation-related complications were observed. Histological examination showed that 35.8% (29/81) patients had malignant tumor and 64.2% (52/81) had benign tumor. Interventional radiology-guided biopsy had a better detection rate compared with gastroscopic biopsy (P < 0.001, χ2 = 64.64).Conclusion: Interventional radiology-guided clamp biopsy is a new esophageal biopsy technique that is minimally invasive, safe, and rapid, with a low rate of missed diagnosis and low requirements regarding the patients' condition. Thus, it is a complementary or auxiliary diagnostic method in cases where the traditional endoscopic approach fails.","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":"143558795","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

Impact of intraoperative recurrent laryngeal nerve monitoring on minimally invasive esophagectomy outcomes for esophageal cancer: a meta-analysis of case-control studies. 术中喉返神经监测对食管癌微创食管切除术预后的影响：病例对照研究的荟萃分析

IF 2.6 3区医学

Diseases of the Esophagus Pub Date : 2025-01-07 DOI: 10.1093/dote/doae116

Rayner Peyser Cardoso, Lokesh Agarwal, Swizel Ann Cardoso, Ayushi Agarwal, Vaibhav Varshney, Subhash Soni, B Selvakumar, Peeyush Varshney

{"title":"Impact of intraoperative recurrent laryngeal nerve monitoring on minimally invasive esophagectomy outcomes for esophageal cancer: a meta-analysis of case-control studies.","authors":"Rayner Peyser Cardoso, Lokesh Agarwal, Swizel Ann Cardoso, Ayushi Agarwal, Vaibhav Varshney, Subhash Soni, B Selvakumar, Peeyush Varshney","doi":"10.1093/dote/doae116","DOIUrl":"10.1093/dote/doae116","url":null,"abstract":"Esophagectomy and lymphadenectomy for esophageal cancer carry an inherent risk of recurrent laryngeal nerve (RLN) injury. Intraoperative nerve monitoring (IONM) may help prevent RLN damage, though evidence on its effectiveness is still limited. This systematic review and meta-analysis (SRMA) evaluate the feasibility and efficacy of IONM during minimally invasive esophagectomy (MIE) for esophageal cancer. This SRMA followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines, with a registered protocol on PROSPERO (CRD42022367916). Two independent authors conducted a comprehensive literature search across multiple databases, screening studies on MIE for esophageal cancer using IONM. Case-control studies were included, focusing on the RLN palsy (RLNP) rate as the primary outcome. A total of 11 studies involving 1907 patients (IONM group: 752 patients; non-IONM group: 1155 patients) were included in the SRMA. IONM significantly reduced the incidence of RLNP (OR = 0.47, P < 0.001). Length of hospital stay (LOHS) and lower respiratory tract infection (LRTI) rates were significantly reduced with IONM use. No significant differences were observed in anastomotic leak, chylothorax, total number of lymph nodes dissected, operation time, aspiration rates, or intraoperative blood loss. The pooled sensitivity and specificity of IONM for detecting RLN injury were 83.3% and 81%, respectively. IONM during MIE significantly reduces the incidence of RLNP, postoperative LRTI, and shortens the LOHS, without adding operative risks. Further research is needed to evaluate its long-term survival benefits and cost-effectiveness.","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":"142856484","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}

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