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Esophagus

February 11, 2020
In this retrospective study of 1760 patients undergoing esophagectomy for cancer at Memorial Sloan Kettering, isolated brain metastases occurred in 2% during follow-up. More than half of those developed within one year of resection. Response to induction therapy was associated with long-term survival in these patients.
January 3, 2020
Using the NCDB, the authors evaluated outcomes for patients with T4a esophageal adenocarcinoma. Receipt of surgery, compared to definitive chemoradiotherapy, offered a significant benefit to overall survival (HR 0.26).  
December 19, 2019
A medium-size RCT on the growing research question of efficacy of peroral myotomy for achalasia, with a 17% failure to improve symptoms in the peroral endoscopic myotomy (POEM) arm, is discussed in this article.
November 26, 2019
A deep-learning computer aided detection (CAD) system was trained to recognize neoplasia using nearly 500,000 endoscopic images.  In head-to-head testing against experienced gastroenterologists using additional images, the accuracy of CAD in diagnosing neoplasia was 88% vs 73% for the gastroenterologists.
November 2, 2019
A batch of staplers manufactured in July-August 2019 and distributed during August-September 2019 has been recalled. Seven serious injuries and one death are reported to have been associated with failure of this device.
November 1, 2019
Commonly, a jejunostomy is placed during esophagectomy. In this report including 188 patients, the impact of jejunostomy on outcomes after esophagectomy was examined. Jejunostomy lead frequently (7%) to jejunostomy-related complications and did not reduce the risk of postoperative weight loss.
October 24, 2019
The National Cancer Database was queried regarding esophageal squamous cancer cases from 2004-2013, and over 11,000 patients were identified. Definitive chemoradiotherapy was used in 79%, whereas resection was employed in 21% at some phase of therapy.
October 17, 2019
Patients with proton-pump inhibitor refractory heartburn have a multitude of underlying causes. In this randomized trial of patients with refractory heartburn, only 21% had symptoms related to gastroesophageal reflux disease. Treatments included fundoplication vs omeprazole and baclofen vs omeprazole.
October 14, 2019
Interesting sizeable series, and a commentary that follows, on what is effectively a thoracic example of Natural Orifice Transluminal Endoscopic Surgery (NOTES).
August 23, 2019
Egyud and colleagues evaluated plasma levels of circulating tumor (ct)DNA in patients with esophageal adenocarcinoma, ranging from stage I to stage IV. The quantity of ctDNA and likelihood of ctDNA detection was greater at later stages, suggesting that it may be challenging to use for early-stage diagnosis.

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