Foregut (Thousand Oaks, Calif.)最新文献_第8页

Esophageal Dilation: Pearls and Pitfalls 食管扩张:珍珠和陷阱

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-08-01 DOI: 10.1177/26345161231189687

K. DeVault

引用次数: 0

Ineffective Esophageal Motility: Discard or Discover? 无效的食管运动:抛弃还是发现?

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-07-28 DOI: 10.1177/26345161231188345

Anand S. Jain

引用次数: 0

Survival Trends and Profiling of Gastric Mixed Adenoneuroendocrine Carcinoma (gMANEC) in the Current Era 当代胃混合型腺神经内分泌癌（gMANEC）的生存趋势和特征

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-07-18 DOI: 10.1177/26345161231188677

Shreya Gupta, James D. Mcdonald, A. J. Rossi, Jonathan M. Hernandez, Jeremy L. Davis, A. Blakely

{"title":"Survival Trends and Profiling of Gastric Mixed Adenoneuroendocrine Carcinoma (gMANEC) in the Current Era","authors":"Shreya Gupta, James D. Mcdonald, A. J. Rossi, Jonathan M. Hernandez, Jeremy L. Davis, A. Blakely","doi":"10.1177/26345161231188677","DOIUrl":"https://doi.org/10.1177/26345161231188677","url":null,"abstract":"Gastric mixed adenoneuroendocrine carcinoma (gMANEC) is a histopathologic diagnosis with at least 30% each of exocrine and endocrine components. Although prognosis is thought to be driven by the relative exocrine or endocrine dominance, gMANEC has been clinically treated as gastric adenocarcinoma (gAC). The overall survival of gMANEC as compared to gastric neuroendocrine carcinoma (gNEC) or gAC remains undefined. Using the National Cancer Database, patients with gastric tumors were queried from 2004 to 2016 for gMANEC, gNEC, and gAC histologies. Demographic and clinicopathologic features were recorded. Univariate and multivariate Cox proportional hazards analyses were performed to delineate factors associated with overall survival (OS). Overall, 404 patients diagnosed with gMANEC were identified. Patients had a median age 68 years, were majority male, and predominantly Caucasian. Gastric MANEC was more frequently poorly differentiated (73%vs 52% (gAC) vs 20% (gNEC), P < .001) with lymphovascular invasion (57%vs 38%vs 27%, P < .001) and lymph node involvement (59%vs 49%vs 36%, P < .001); these factors were associated with worse OS on univariable analysis. Finally, tumors >5 cm and lymph node involvement were independent predictors of worse survival. The median OS of patients with gMANEC was 41.5 months. Gastric MANEC and gAC have a similarly dismal prognosis and thus should be continued to treat like gAC. Pathologic nodal metastasis, tumor size and grade are useful prognostic factors.","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46997543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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 the SARS-CoV-2 Pandemic on Treatment Pathways and Outcomes of Esophagogastric Cancer: A Pre- Versus Post-Pandemic Comparison of International Prospective Cohort Data SARS-CoV-2大流行对食管胃癌治疗途径和结局的影响:国际前瞻性队列数据的大流行前后比较

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-07-17 DOI: 10.1177/26345161231175981

E. Griffiths, S. Kamarajah

{"title":"Impact of the SARS-CoV-2 Pandemic on Treatment Pathways and Outcomes of Esophagogastric Cancer: A Pre- Versus Post-Pandemic Comparison of International Prospective Cohort Data","authors":"E. Griffiths, S. Kamarajah","doi":"10.1177/26345161231175981","DOIUrl":"https://doi.org/10.1177/26345161231175981","url":null,"abstract":"Introduction: This study aimed to characterize the outcomes of esophagogastric (OG) cancer patients and compare perioperative outcomes with pre-pandemic data. Methods: Three international prospective cohort studies were included in this analysis. First, COVIDSurg-Cancer (n = 1999) included patients with an OG cancer planned for surgery from the start of the pandemic up to 14th April 2020 with follow-up until 31st August 2020. Treatment pathways and outcomes were compared against patients undergoing treatment for OG cancers before the pandemic, Oesophagogastric Anastomosis Audit (OGAA, n = 2246) and GlobalSurg 3 (n = 1256) study. The surgical composite outcome was defined as in patients achieving margin negative resection, resectability and no postoperative mortality. Results: This study included 1999 patients during the COVID-19 pandemic, of which 32.4% had a change from standard pre-pandemic management. Patients with delay to surgery had significantly higher rates of no surgery (24.7%vs 7.5%, P < .001) and less likely to have achieve a composite outcome (57.8%vs 73.4%, P < .001) than those without any delay in surgery. There was no significant difference in 30-day mortality (3.5% vs 3.4%; OR: 0.98, CI95%: 0.69-1.37) or anastomotic leak rate (10.9% vs 10.2%%; OR: 1.11, CI95%: 0.90-1.37) but higher reoperation rates (13.6% vs 10.4%; OR: 1.59, CI95%: 1.30-1.92) in patients between pre-pandemic and pandemic cohorts. Conclusion: The pandemic appears to have led to widespread changes in management pathways affecting one-third of patients. Developing elective surgical pathways resilient to periods of system “stress” are key to minimizing future harm from treatment delay for OG cancer patients.","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90313877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Safety and Outcomes of Bariatric Surgery in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis 炎症性肠病患者减肥手术的安全性和结果:系统回顾和荟萃分析

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-07-12 DOI: 10.1177/26345161231185780

Hillary Wilson, K. Verhoeff, J. Dang, J. Kung, N. Switzer, D. Birch, K. Madsen, S. Karmali, V. Mocanu

{"title":"Safety and Outcomes of Bariatric Surgery in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis","authors":"Hillary Wilson, K. Verhoeff, J. Dang, J. Kung, N. Switzer, D. Birch, K. Madsen, S. Karmali, V. Mocanu","doi":"10.1177/26345161231185780","DOIUrl":"https://doi.org/10.1177/26345161231185780","url":null,"abstract":"The need for surgical management of severe obesity in the context of inflammatory bowel disease (IBD) is becoming an increasingly common clinical scenario, yet has been met with significant reservation due to the paucity of current data from which to inform evidence-based clinical decision making. The aim of our study was to perform a systematic review to characterize and evaluate the safety and efficacy of bariatric surgery in IBD patients. A medical librarian developed and executed comprehensive searches on November 2, 2021. The population of interest was adult subjects (>18 years) diagnosed with inflammatory bowel disease (IBD) undergoing any type of bariatric surgery. Meta-analysis was used to evaluate outcomes using RevMan 5.4.1. A total of 330 687 patients were identified within the 11 studies included. Within all included studies there were 1595 patients with IBD. Patients had a mean weighted age of 46.0, with a female predominance (n = 1287, 80.7%). The mean duration of follow up was 39.7 months. Metabolic and anthropometric outcomes were only reported in noncomparative studies evaluating only patients with IBD, limiting the ability to complete meta-analysis. Meta-analysis revealed that IBD was associated with increased rates of postoperative complications (RR 2.14; 95% CI 1.87-2.44; P < .00001) in comparison to controls without IBD. While bariatric surgery presents an effective weight loss option for patients with IBD, these patients are associated with higher rates of postoperative complications. This work highlights the need to better delineate the effect of bariatric procedures for patients with IBD with respect to both metabolic and IBD-related outcomes.","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47529241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Potassium-Competitive Acid Blockers for the Treatment of Gastroesophageal Reflux Disease 钾竞争性酸阻滞剂治疗胃食管反流病

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-07-08 DOI: 10.1177/26345161231181357

J. Kothadia, C. Howden

引用次数: 0

Abdominal Wall Hernias in Patients with Hiatal Hernias: Predictors of Association in a Large Cohort of Patients Hiatal疝患者的腹壁疝：一组患者中相关性的预测因素

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-06-22 DOI: 10.1177/26345161231180010

Nisarg Mehta, Sven E. Eriksson, P. Zheng, I. Sarici, A. Zaidi, B. Jobe, S. Ayazi

{"title":"Abdominal Wall Hernias in Patients with Hiatal Hernias: Predictors of Association in a Large Cohort of Patients","authors":"Nisarg Mehta, Sven E. Eriksson, P. Zheng, I. Sarici, A. Zaidi, B. Jobe, S. Ayazi","doi":"10.1177/26345161231180010","DOIUrl":"https://doi.org/10.1177/26345161231180010","url":null,"abstract":"Hiatal hernia and abdominal wall hernia (AWH) have a common theme of pathogenesis and etiology. This suggests a potential relationship between these 2 types of hernia. However, no large studies have examined such an association. We designed the current study to characterize this association and identify factors associated with this coexistence. A database of patients seen at a large multi-center health network serving 3 states in the mid-Atlantic region of the United States was queried for patients with a documented diagnosis of hiatal hernia (HH) or paraesophageal hernia (PEH). This population was then divided into groups based on whether or not they had a history of another type of AWH (ventral, inguinal/ femoral, umbilical, or incisional hernia). Demographic and clinical data were compared between groups using univariate, followed by multivariable logistic analysis. The final study population consisted of 28 114 patients (66.5% female) with HH/PEH. The prevalence of AWH in this population was 8.2% (n = 2299). Of these 69.1% had only one AWH with the remaining 30.9% having two or more hernias. Multivariable analysis showed male patients with HH/PEH were more likely to have AWH (OR: 1.97; 95% CI: 1.810-2.162, P <0 .0001). The odds of AWH were higher in patients aged 50 to 80 years old compared to younger patients (OR: 1.527; 95% CI: 1.348-1.730, P <0 .0001). Patients with any comorbidity were also more likely to develop AWH (OR: 1.764; 95% CI: 1.566-1.986, P < 0.0001), with obstructive sleep apnea (OSA) being the comorbidity with the highest risk (OR: 1.295; 95% CI: 1.161-1.444, P <0 .0001), followed by obesity (OR: 1.267; 95% CI: 1.156-1.388, P <0 .0001). The prevalence of an AWH in patients with a HH/PEH was 8.2%. Although HH/PEH are more prevalent in females, males with HH/PEH are at higher risk for AWH. Obesity, OSA, tobacco use, hypertension, diabetes, and hypothyroidism are independent risk factors for presence of an AWH in patients with HH/PEH.","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49595830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Understanding the Spectrum of Esophageal Cancer Disparities 对食管癌症差异谱的理解

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-06-21 DOI: 10.1177/26345161231182108

Malhar J. Parikh, Nielsen M. Gabriel, V. Gryszko, C. Erkmen

引用次数: 1

Key Decision Making and Technical Aspects of Performing Transoral Incisionless Fundoplication 实施经口无切口手术的关键决策和技术方面

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-06-04 DOI: 10.1177/26345161231176080

Aryan Meknat, A. Kulkarni, Thaer Abdelfatteh, H. C. Fernando

引用次数: 0

Transthoracic Approach to Reoperative Antireflux Surgery 再手术抗反流手术经胸入路

Foregut (Thousand Oaks, Calif.) Pub Date : 2023-06-02 DOI: 10.1177/26345161231178348

L. Schaheen, R. Bremner

引用次数: 0