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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
{"title":"Understanding the Spectrum of Esophageal Cancer Disparities","authors":"Malhar J. Parikh, Nielsen M. Gabriel, V. Gryszko, C. Erkmen","doi":"10.1177/26345161231182108","DOIUrl":"https://doi.org/10.1177/26345161231182108","url":null,"abstract":"Esophageal cancer carries an immense burden of disease. Despite advances in cancer care, the survival rate of esophageal cancer has not significantly improved over the last 30 years. The burden of disease is greater on minorities, immigrants, and lower socioeconomic groups in the United States. Research has consistently shown that these communities suffer from persistently worse outcomes. Minorities are noted to have increased risk of developing esophageal cancer, have worse stage at presentation, and limited access to the newest advancements and best treatment options. The reason for these disparities is multifactorial and the US health system must address and correct the underlying reasons to ensure just health care for all.","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44065815","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: 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
{"title":"Key Decision Making and Technical Aspects of Performing Transoral Incisionless Fundoplication","authors":"Aryan Meknat, A. Kulkarni, Thaer Abdelfatteh, H. C. Fernando","doi":"10.1177/26345161231176080","DOIUrl":"https://doi.org/10.1177/26345161231176080","url":null,"abstract":"There are a wide variety of surgical therapeutic options for GERD—ranging from laparoscopic fundoplication, magnetic sphincter augmentation, to advanced endoscopic interventions (eg, transoral incisionless fundoplication, TIF). TIF has emerged as the predominant endoscopic approach for GERD, supported by several randomized trials highlighting the efficacy of this procedure. Its safety profile has similarly been well established. The key to properly utilizing this procedure is patient selection. We here in describe the efficacy, highlight key decision making and technical aspects of performing a TIF, to discuss post-operative care and complications.","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":"3 1","pages":"332 - 337"},"PeriodicalIF":0.0,"publicationDate":"2023-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66050441","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
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
{"title":"Transthoracic Approach to Reoperative Antireflux Surgery","authors":"L. Schaheen, R. Bremner","doi":"10.1177/26345161231178348","DOIUrl":"https://doi.org/10.1177/26345161231178348","url":null,"abstract":"Reoperative antireflux surgery (ARS) is complex and often needs to be customized to the individual patient. A transthoracic approach is preferred in select patients with concomitant esophageal pathologies or a complex surgical history. The clinical presentation and perioperative evaluation of patients who require reoperative ARS as well as surgical options, the role of the transthoracic approach, and Nissen and Belsey Mark IV fundoplication techniques are discussed in detail. Outcomes associated with the transthoracic approach to reoperative ARS are reviewed. Although less invasive laparoscopic approaches have become more common, the transthoracic approach must remain in the foregut surgeon’s armamentarium.","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45418827","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
The Esophagogastric Junction Integrity 食管胃交界完整性
Foregut (Thousand Oaks, Calif.) Pub Date : 2023-06-01 DOI: 10.1177/26345161231170426
Salih Samo
{"title":"The Esophagogastric Junction Integrity","authors":"Salih Samo","doi":"10.1177/26345161231170426","DOIUrl":"https://doi.org/10.1177/26345161231170426","url":null,"abstract":"To the editor, I read with great interest the article “The American Foregut Society white paper on the endoscopic classification of esophagogastric junction integrity”1 published in the journal. The newly proposed American Foregut Society (AFS) classification to grade the antireflux barrier (ARB) integrity provides more comprehensive evaluation that are relevant to the practicing clinicians in day-to-day practice. The authors appropriately call for future validation of this novel classification and its correlation with the presence and severity of gastroesophageal reflux disease, and additionally to extend the classification to assess the ARB integrity in individuals with prior antireflux interventions,1 whether surgical or endoscopic. However, the future directions fall short of addressing 2 important variables that may affect the assessment of ARB integrity by applying the AFS classification. First, the classification does not take into consideration the anesthesia effect on the ARB. The hiatal aperture tends to be larger under general anesthesia with use of paralytics as compared to conscious sedation without the use of paralytics. Second, the novel AFS classification does not take obesity into consideration either. It is common to see a large fat pad in the diaphragmatic hiatus during laparoscopy, which may prevent accurate appreciation of a hidden hiatal hernia, whether endoscopically or laparoscopically. Therefore, caution needs to be taken when evaluating for hiatal hernia in obese patients, and other modalities, such as upper gastrointestinal contrast study, should be used to assess for presence of hiatal hernias.2 Addressing these 2 important issues is of paramount importance in future studies. Declaration of Conflicting Interests","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":"29 1","pages":"235 - 235"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75540682","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: 1
Sex Differences in Gastroesophageal Reflux Disease (GERD) 胃食管反流病(GERD)的性别差异
Foregut (Thousand Oaks, Calif.) Pub Date : 2023-06-01 DOI: 10.1177/26345161231166136
Daniel Scheese, Mohamad Chehab, C. A. Puig
{"title":"Sex Differences in Gastroesophageal Reflux Disease (GERD)","authors":"Daniel Scheese, Mohamad Chehab, C. A. Puig","doi":"10.1177/26345161231166136","DOIUrl":"https://doi.org/10.1177/26345161231166136","url":null,"abstract":"Gastroesophageal reflux disease (GERD) is the most commonly diagnosed digestive disorder in the United States. Higher rates of non-erosive reflux disease (NERD) are found in females while higher rates of erosive reflux disease (ERD) are found in males. Pre-menopausal females appear to be protected from esophageal mucosal damage, as they demonstrate lower rates of ERD, Barrett’s esophagus, and esophageal adenocarcinoma. A protective effect of estrogen on the esophageal mucosa is thought to contribute to this decreased prevalence. A better understanding of sex-related differences in GERD may help alleviate the reported differences in outcomes between sexes regarding medical and surgical management.","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":"3 1","pages":"192 - 198"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66050352","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
Reply to the Esophagogastric Junction Integrity 对食管胃交界完整性的回答
Foregut (Thousand Oaks, Calif.) Pub Date : 2023-06-01 DOI: 10.1177/26345161231170423
N. Nguyen, K. Chang, M. Canto, J. Lipham, R. Bell, P. Kahrilas
{"title":"Reply to the Esophagogastric Junction Integrity","authors":"N. Nguyen, K. Chang, M. Canto, J. Lipham, R. Bell, P. Kahrilas","doi":"10.1177/26345161231170423","DOIUrl":"https://doi.org/10.1177/26345161231170423","url":null,"abstract":"We thank the reader for their letter and interest in the American Foregut Society (AFS) endoscopic classification of esophagogastric junction (EGJ) integrity.1,2 The reader raised 2 issues regarding potential limitations of our approach. First, it does not consider the effect of anesthesia and the reader commented on the observation that the hiatal aperture tends to enlarge under general anesthesia with the use of paralytics as compared to conscious sedation endoscopy. While this observation is interesting, we are not advocating doing routine upper endoscopy under general anesthesia. It is also worth noting that we were more driven by endoscopic undergrading of hiatal integrity due to insufficient gastric insufflation rather than overgrading, even going so far as to advocate eliciting a hernia with a provocative endoscopic maneuver. The second observation from the reader is that obese patients commonly have a large fat pad at the level of the hiatus that may preclude an accurate depiction of the hiatal defect. We agree that this can lead to “undergrading” the EGJ and should be kept in mind with obese patients. It also emphasizes the need to utilize maximal insufflation of the stomach and provocative maneuvers to elicit a sliding hiatal hernia. However even if the fat pad leads to an underestimation of the hiatus grade, it would not obscure an AFS grade II which is a key difference between AFS grading and the Hill classification. An AFS grade II is considered pathologic, representing partial hiatus disruption with loss of the intraabdominal esophageal length along with the gastroesophageal flap valve and the angle of His. In contrast, a Hill grade II is considered to be a normal finding. We thank the reader for their interest and astute comments. Declaration of Conflicting Interests","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":"7 1","pages":"236 - 236"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81485456","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
Analysis of Reported Adverse Events Associated With the Use of Functional Lumen Imaging Probe Devices in the Esophagus and Stomach: An FDA MAUDE Database Study 与食道和胃使用功能性管腔成像探头装置相关的不良事件分析:FDA MAUDE数据库研究
Foregut (Thousand Oaks, Calif.) Pub Date : 2023-06-01 DOI: 10.1177/26345161231191696
F. Jaber, W. Johnson, N. Wilson, Saqr Alsakarneh, Mouhand F. H. Mohamed, K. Ahmed, Nicole Patel, B. Hanson, Mohamed Abdallah, M. Bilal
{"title":"Analysis of Reported Adverse Events Associated With the Use of Functional Lumen Imaging Probe Devices in the Esophagus and Stomach: An FDA MAUDE Database Study","authors":"F. Jaber, W. Johnson, N. Wilson, Saqr Alsakarneh, Mouhand F. H. Mohamed, K. Ahmed, Nicole Patel, B. Hanson, Mohamed Abdallah, M. Bilal","doi":"10.1177/26345161231191696","DOIUrl":"https://doi.org/10.1177/26345161231191696","url":null,"abstract":"The endoscopic Functional Lumen Imaging Probe (FLIP) devices are used to evaluate pressure changes, diameter, and volume of the esophagus. We used the FDA’s MAUDE database to collect post-marketing surveillance data on these devices from January 2009 to September 2022. Forty-Five device-related events and thirty-six patient-related adverse events were analyzed. The most common device issue for the diagnostic FLIP device was therapeutic/diagnostic failure (n = 6), while the most frequent issue with the therapeutic FLIP device was adverse events without an identified device or use problem (n = 11). Patient-related adverse events were extremely rare with the diagnostic FLIP and the most common patient-related adverse event with the therapeutic FLIP was perforation (n = 11). Endoscopists need to be mindful of these potential technical issues and adverse events while using these devices.","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":"3 1","pages":"338 - 343"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66050981","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
The Impact of Disparities on Minimally Invasive Esophagectomy After the 2014 Affordable Care Act Expansion: A Retrospective Analysis 2014年平价医疗法案扩大后微创食管切除术差异的影响:回顾性分析
Foregut (Thousand Oaks, Calif.) Pub Date : 2023-06-01 DOI: 10.1177/26345161231178351
Avanti Badrinathan, Thomas A. Syphan, A. Bassiri, J. Linden, Christine E. Alvarado, Jillian N. Sinopoli, Leonidas Tapias Vargas, C. Towe
{"title":"The Impact of Disparities on Minimally Invasive Esophagectomy After the 2014 Affordable Care Act Expansion: A Retrospective Analysis","authors":"Avanti Badrinathan, Thomas A. Syphan, A. Bassiri, J. Linden, Christine E. Alvarado, Jillian N. Sinopoli, Leonidas Tapias Vargas, C. Towe","doi":"10.1177/26345161231178351","DOIUrl":"https://doi.org/10.1177/26345161231178351","url":null,"abstract":"The effect of Affordable Care Act Medicaid expansion on access to minimally invasive esophagectomy (MIE) is unknown. We hypothesize that greater Medicaid coverage resulting from ACA expansion would be associated with improved access to MIE, and performed an analysis of the National Cancer Database, comparing MIE rates in Medicaid expansion states to non-expansion states. MIE was more common in expansion states (30.37%vs 23.88%, P < .001). A multivariable difference-in-differences analysis, however, suggested no effect in MIE rate due to Medicaid expansion. This finding suggests that access to care is more complex than access to insurance. Further study is required to characterize disparities in access to MIE.","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":"36 1","pages":"199 - 207"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77284863","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
Disparities in Benign and Malignant Foregut Disease 良性和恶性前肠疾病的差异
Foregut (Thousand Oaks, Calif.) Pub Date : 2023-06-01 DOI: 10.1177/26345161231175993
V. Litle
{"title":"Disparities in Benign and Malignant Foregut Disease","authors":"V. Litle","doi":"10.1177/26345161231175993","DOIUrl":"https://doi.org/10.1177/26345161231175993","url":null,"abstract":"","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":"1 1","pages":"139 - 140"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79537715","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
Critical Decision Making: Endoscopic Pyloromyotomy 关键决策:内窥镜幽门切开术
Foregut (Thousand Oaks, Calif.) Pub Date : 2023-05-30 DOI: 10.1177/26345161231178352
Lee L. Swanstöm
{"title":"Critical Decision Making: Endoscopic Pyloromyotomy","authors":"Lee L. Swanstöm","doi":"10.1177/26345161231178352","DOIUrl":"https://doi.org/10.1177/26345161231178352","url":null,"abstract":"Endoscopic pylormyotomy is a new very minimally invasive treatment option for delayed gastric emptying—an increasingly common clinical problem. However, as with any novel procedure, critical decision-making is necessary to ensure optimal patient outcomes. In this article, we discuss the various factors that should be considered when deciding whether to perform G-POEM, including patient selection, pre-operative workup including newer dynamic test modalities, technical considerations, and post-operative management. We also highlight potential complications and their management. By understanding the critical decision-making process involved in G-POEM, physicians can optimize patient outcomes and improve overall success rates of this procedure.","PeriodicalId":73049,"journal":{"name":"Foregut (Thousand Oaks, Calif.)","volume":"3 1","pages":"303 - 306"},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66050489","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
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