bluuebunny/crossref_metadata_2025_split huggingface dataset:
Precision in 3-Dimensional Surface Imaging of the Face: A Handheld Scanner Comparison Performed in a Cadaveric Model
Authors: Koban Konstantin C , Cotofana Sebastian , Frank Konstantin , Green Jeremy B , Etzel Lucas , Li Zhouxiao , Giunta Riccardo E , Schenck Thilo L 
Published: September 2018

Abstract

Background
Handheld 3-dimensional surface imaging (3DSI) devices of various precision are becoming more versatile in their applications and more widely accepted by clinicians for documentation.

Objectives
The authors sought to compare the precision of facial volumetric change measurements of 3 3DSI devices in the cadaveric model: Eva (Artec 3D Inc., Luxembourg), Sense (3D Systems, Rock Hill, SC), and iSense (3D Systems, Rock Hill, SC).

Methods
A total of 336 scanning and analysis procedures were carried out in 4 cephalic specimens (mean age, 77.25 ± 24.3 years; mean BMI, 21.76 ± 6.6 kg/m2). Two superficial and 2 supraperiosteal regions of interest were injected with 0.5-cc aliquots and subsequently scanned using the 3 different scanners. Correlation coefficients between the injected and measured volume were computed.

Results
The correlation coefficient for the Eva scanner was for subcutaneous regions of interest rp = 0.935 and for the supraperiosteal regions of interest rp = 0.966, compared with rp = 0.760 and rp = 0.364 (superficial vs supraperiosteal) for the Sense and rp = 0.694 and rp = 0.382 (superficial vs supraperiosteal) for the iSense scanner.

Conclusions
3DSI devices are capable of measuring surface volume changes of the face at a level of 0.5-cc surface volume change and can thus be regarded as useful tools in the preinterventional, intrainterventional, and postinterventional phases of a treatment. One of the 3 evaluated scanners provided very high correlation coefficients between the injected and the measured volume (Eva), whereas the other evaluated 3DSI devices provided moderate (Sense) and low (iSense) coefficients.
FA04.02: JAPANESE MULTICENTER PROSPECTIVE STUDY FOR ESOPHAGOGASTRIC JUNCTION CANCER
Authors: Mine Shinji , Kurokawa Yukinori , Takeuchi Hiroya , Sano Takeshi , Terashima Masanori , Yoshida Kazuhiro , Yasuda Takushi , Daiko Hiroyuki , Sakuramoto Sinich , Kunisaki Chikara , Yoshikawa Takaki , Tamura Shigeyuki , Seto Yasuyuki , Kitagawa Yuko , Doki Yuichiro 
Published: September 2018

Abstract

Background
Lymph node metastasis from esophagogastric junction (EGJ) cancer is multi-directional, and the previously reported incidences in each nodal station are heavily biased by different operative approaches. We conducted a multicenter prospective study using a standardized surgical protocol of lymphadenectomy.

Methods
This study is a single-arm, multi-institutional, prospective study. Patients with resectable cT2–4 EGJ cancer were eligible, regardless of neoadjuvant therapy. The primary endpoint was the metastasis rate of each lymph nodal station. The planned sample size was 360, and the entry period was 4 years. Protocol of surgical procedure: Patients diagnosed as having EGJ adenocarcinoma with esophageal invasion > 3 cm or with upper/middle mediastinal lymph node involvement, or those having EGJ squamous cell carcinoma, underwent an esophagectomy via right thoracotomy or thoracoscopy. The lymphadenectomy included the upper/middle/lower mediastinum, paracardiac region, around the celiac axis, and the left renal vein area (16a2lat). Patients with EGJ adenocarcinoma with esophageal invasion ≤ 3 cm underwent transhiatal lower esophagectomy and gastrectomy with lymphadenectomy of the lower mediastinum, paracardiac region, around the celiac axis, and 16a2lat.

Results
From April 2014 to September 2017, 371 patients were enrolled in this study from 42 institutions. As 8 patients were excluded due to protocol violations and later refusals, 363 patients were analyzed finally. Of 363 patients, 332 (91.4%) had adenocarcinoma and 31 (8.5%) had SCC. 86 patients (23.7%) had cT2 tumors and the other 277 (76.3%) had cT3–4 tumors. 134 patients (36.9%) had cN0 and the other 229 (63.1%) had cN + disease. Neo-adjuvant treatments (mostly chemotherapy) were given to only 121 patients (33.3%). Esophagectomies were performed in 121 patients (33.3%) and extended gastrectomies were performed in 236 (65.0%). Resection with R0 was achieved in 339 (93.4%). Based on histological examinations, the incidences of nodal involvements in each area were as follows: upper mediastinum (9/118, 7.6%); middle mediastinum (14/128, 10.9%); lower mediastinum (47/353, 13.3%); abdominal (240/358, 67.0%); the left renal vein area (16A2lat) (18/344, 5.2%).

Conclusion
For patients with EGJ cancers, the incidences of nodal involvements in the upper mediastinum and the left renal vein area (16A2lat) were lower than our expectations.

Disclosure
All authors have declared no conflicts of interest.
FA04.04: IMPORTANT STEPS AND FIRST RESULTS OF FULLY ROBOTIC IVOR-LEWIS ESOPHAGEAL RESECTION (RAMIE4) FOR ESOPHAGEAL AND ESOPHAGOGASTRIC JUNCTION CANCER
Authors: Grimminger Peter , Hadzijusufovic Edin , Babic Benjamin , Matthias Corvinus Florian , Lang Hauke 
Published: September 2018

Abstract

Background
Robotic-assisted surgery is increasing, especially in general tumor surgery. Minimal-invasive esophagectomy (MIE) is commonly the standard operation procedure in high-volume centers. Also the fully robotic minimally invasive esophagectomy using 4 robotic arms in the abdomen and thorax (RAMIE4) is performed more frequent. The advantages of RAMIE4 as well as advantages and disadvantages of special steps in the procedure and reconstruction are not clear so far and are under comparison with other MIE techniques.

Methods
Form January 2017 until March 2018 we prospectively collect the first 50 fully robotic RAMIE4 cases performed by one specialized surgeon and additionally the 50 MIE cases performed by the same surgeon between 2016 and 2017.

Results
At the meeting we will present our RAMIE4 results of the first 50 cases operated by one specialized surgeon and compare those results with the 50 MIE cases of the same surgeon. Additionally essential steps of the RAMIE4 procedure will be presented.

Conclusion
In our opinion RAMIE4 is feasible and offers great potential, especially for lymph node dissection, surgical precision, future potential, teaching and advanced ergonomics. The overall advantages have to be proven in randomized trials by specialized surgeons in MIE and RAMIE.

Disclosure
All authors have declared no conflicts of interest.
FA05.04: CLINICAL SIGNIFICANCE OF ESOPHAGEAL INVASION LENGTH FOR THE PREDICTION OF MEDIASTINAL LYMPH NODE METASTASIS IN SIEWERT TYPE II ADENOCARCINOMA
Authors: Koyanagi Kazuo , Kato Fumihiko , Kanamori Jun , Daiko Hiroyuki , Tachimori Yuji , Ozawa Soji 
Published: September 2018

Abstract

Background
We focused on the esophageal invasion length (EIL), defined as the distance from the EGJ to the proximal edge, of Siewert type II adenocarcinomas. This study investigated whether the EIL could be a possible indicator of mediastinal lymph node metastasis and survival in the Siewert type II patients.

Methods
The 168 consecutive patients with Siewert type II tumor who underwent surgery were enrolled. Metastatic stations and recurrent lymph node sites were classified into cervical, upper/middle/lower mediastinal, and abdominal zones. EIL was correlated with overall metastasis or recurrence in individual zones and survival.

Results
The ROC curve for EIL was generated to predict the rates of upper and middle mediastinal lymph node metastasis or recurrence, and the cut-off EIL value was determined to be 25 mm with an area under the curve of 0.83 (sensitivity, 80.8%; specificity, 72.3%). Siewert type II patients with an EIL of more than 25 mm (> 25 mm EIL group) had a higher incidence of overall metastasis or recurrence in the upper and middle mediastinal zones than those with an EIL of less than or equal to 25 mm (≤ 25 mm EIL group) (P = 0.001 and P < 0.001). Disease free and overall survival in the > 25 mm EIL group were significantly lower than those of the ≤ 25 mm EIL group (P < 0.001). None of the Siewert type II patients with metastasis or recurrence in the upper and middle mediastinal zones survived for more than five years. On the other hand, the efficacy index of the lower mediastinal lymph node and the abdominal lymph node were 5.6 and 21.7, respectively. Only EIL of more than 25 mm was a significant preoperative predictor of overall metastasis or recurrence in the upper and middle mediastinal zone (odds ratio, 8.85; 95% CI, 2.31−33.3; P = 0.001).

Conclusion
An EIL of more than 25 mm might be a preoperative predictor of overall metastasis or recurrence in the upper and middle mediastinal zones. A multimodal-therapeutic strategy should be investigated in Siewert type II patients once the tumor has invaded to the esophageal wall more than 25 mm.

Disclosure
All authors have declared no conflicts of interest.
FA06.06: CLINICAL UTILITY OF YPTNM STAGE GROUPING IN AJCC 8TH EDITION FOR JAPANESE PATIENTS WITH ESOPHAGEAL SQUAMOUS CELL CARCINOMA
Authors: Ichikawa Hiroshi , Sudo Natsuru , Kosugi Shin-Ichi , Hanyu Takaaki , Ishikawa Takashi , Kano Yosuke , Muneoka Yusuke , Otani Takahiro , Nemoto Mariko , Bamba Takeo , Nakagawa Satoru , Kameyama Hitoshi , Wakai Toshifumi 
Published: September 2018

Abstract

Background
The 8th edition of the American Joint Committee on Cancer staging (AJCC-8th) of esophageal cancer presents independent stage grouping for patients who underwent neoadjuvant therapy followed by esophagectomy (ypTNM). The aim of this study is to elucidate the clinical utility of ypTNM stage grouping in Japanese patients with esophageal squamous cell carcinoma (ESCC).

Methods
A total of 146 patients (121 men and 25 women, with a median age of 65 years) who underwent curative esophagectomy following neoadjuvant chemotherapy with cisplatin and 5-fluorouracil (CF) for ESCC between 2005 and 2011 were enrolled in this retrospective study. We compared the distribution of patients and disease-specific survival after esophagectomy (DSS) stratified by ypStage between AJCC-7th and 8th. Additionally, we evaluated the association between clinicopathological features including ypStage in AJCC-8th and DSS.

Results
The number of patients classified into ypStage 0/IA/IB/IIA/IIB/IIIA/IIIB/IIIC/IV was 5/1/14/11/35/40/18/18/4 in AJCC-7th, and that classified into ypStage I/II/IIIA/IIIB/IVA/IVB was 27/18/21/58/18/4 in AJCC-8th. According to the revision from AJCC-7th to 8th, ypStage of 85 and 7 patients was up- and down-graded, respectively. Up-grading of ypStage was observed in 83% of patients with ypT4 tumor and in 78% of patients with ypN1–3. The 5-year DSS of ypStage 0/IA/IB/IIA/IIB/IIIA/IIIB/IIIC/IV was 100/100/93/91/75/62/50/28/50% in AJCC-7th, and that of ypStage I/II/IIIA/IIIB/IVA/IVB was 96/83/68/58/28/50% in AJCC-8th. The 5-year DSS of ypStage III was 61% in AJCC-8th comparing to 51% in AJCC-7th, and that of ypStage IV was 31% in AJCC-8th comparing to 50% in AJCC-7th. Univariate analyses identified ypT-8th (P = 0.028), ypN-8th (P < 0.001), cStage-8th (P = 0.006) and ypStage-8th (P < 0.001) in addition to surgical procedure (P = 0.027) and histological response (P = 0.019) as significant prognostic factors for DSS. Among these, multivariate analysis showed that ypStage-8th was a significant independent prognostic factor for DSS (P < 0.001).

Conclusion
ypTNM stage grouping in AJCC-8th can more accurately stratify the prognosis of patients who underwent neoadjuvant CF therapy for ESCC, by classifying patients with residual tumor invasion to adjacent structures and regional lymph node metastasis into more unfavorable prognostic group than that in AJCC-7th. ypStage according to AJCC-8th is the most reliable prognosticator for this disease.

Disclosure
All authors have declared no conflicts of interest.
PS01.001: CARCINOMA IN ESOPHAGEAL ACHALASIA: WHO, WHEN AND HOW
Authors: Vinicius  , Mazzini Guilherme , Felipe Juchem José , Gurski Richard 
Published: September 2018

Abstract

Background
Esophageal achalasia is a precancerous condition for epidermoid carcinoma; prevalence and risk factors for cancer development are not defined. Aim of the study was to determine these parameters.

Methods
Achalasia patients observed in the period 1955-2016, since 1973 were periodically submitted to clinical assessment, barium swallow (esophageal diameter and residual barium column were measured), endoscopy, according to a prospective protocol. In this study we included patients with a minimum 12 months follow-up, endoscopy or radiology at the last control. Follow up was discontinued for decision or death of patients.

Results
Five hundred and eighty-three of 681 cases were considered. The median follow-up was 147.13 months (IQR 70.42-257.82 months); 17 epidermoid, 1 carcinosarcoma were diagnosed (30.8/1000 cases). At multivariate analysis esophageal diameter (p < 0.001), residual barium column (p < 0.05) and duration of dysphagia (p < 0.001) were independent risk factors. Conversely, the risk of epidermoid carcinoma development decreased after residual barium swallow decrease (p < 0.05), consequent to efficacious therapy. According to classification tree (Figure), patients with severe dysphagia at the last clinical-radiological control and sigmoid esophagus experienced a risk of epidermoid carcinoma development equal to 48.6%. classification tree for squamous cell carcinoma. o outcome; se sigmoid esophagus.jpg

Conclusion
End-stage achalasia and dysphagia lasting longer than 22 years are risk factors for development of epidermoid cancer. Effective Heller myotomy can interrupt the carcinogenetic process in the presence of end-stage achalasia. Patients who overcome the risk parameters, should be offered esophagectomy or conservative surgery followed by strict endoscopic surveillance.

Disclosure
All authors have declared no conflicts of interest.
PS01.010: CLINICAL AND FUNCTIONAL RESULTS OF PULL-DOWN HELLER-DOR AND ESOPHAGECTOMY FOR END-STAGE ACHALASIA: A PROSPECTIVE STUDY
Authors: Tassi Valentina , Lugaresi Marialuisa , Mattioli Benedetta , Daddi Niccolò , Mattioli Sandro 
Published: September 2018

Abstract

Background
The Heller-Dor associated with the verticalization of distal esophagus (pull-down technique PD-HD) or esophagectomy (E) may be indicated for therapy of dysphagia in end-stage achalasia the latter also prevents development of carcinoma. We compared results achieved after PD-HD and E.

Methods
Twenty-nine patients (median age 57 years IQR 49–69 years) were submitted to PD-HD and 20 patients (median age 64 years IQR 56–69 years) (P = 0.321) were submitted to E for end stage achalasia or for cancer (patients recurrence free). We adopted semi quantitative scales to investigate dysphagia, reflux symptoms and esophagitis. With SF-36 quality of life was assessed.

Results
Median follow-up was 134.13 months (IQR 92.36 - 167.03 months) for PD-HD and 42.77 months (IQR 23.57 - 65.17 months) for E (P = 0.001). No statistically significant differences were observed with regards to the objective evaluation of dysphagia, reflux symptoms and esophagitis (P = 0.515). No statistically significant differences were calculated between the two groups as it concerns the domains general health (P = 0.302), physical functioning (P = 0.275), role physical (P = 0.107) and bodily pain (P = 0.057). Significant differences with regards to the domains role emotional (PD-HD 100, E 75, P = 0.012), vitality (PD-HD 90, E 60, P < 0.001), mental health (PD-HD 92, E 69, P = 0.001) and social functioning (PD-HD 100, E 75, P = 0.014) were observed in favour of PD-HD (Figure).

Conclusion
With respect to E, PD-HD achieved similar dysphagia, GER control, better quality of life. PD-HD is the procedure of choice for patients with low or null risk for cancer.

Disclosure
All authors have declared no conflicts of interest.
PS01.011: PATHOPHYSIOLOGY OF LARYNGOPHARYNGEAL REFLUX DISEASE: ASSOCIATION WITH PULMONARY ASPIRATION ON SCINTIGRAPHY AND INEFFECTIVE OESOPHAGEAL MOTILITY
Authors: Khoma Oleksandr , Falk Michael , Van Der Wall Hans , Burton Leticia , Falk Gregory 
Published: September 2018

Abstract

Background
Gastro-oesophageal reflux disease (GORD) can present with typical symptoms or atypical or laryngopharyngeal reflux (LPR) symptoms. The role of impaired oesophageal motility in these two clinically distinct groups has not been previously examined.

Methods
This study is a retrospective analysis of 361 consecutive patient records that was extracted from a prospectively populated research database. Patients were categorised by symptom profile as predominantly LPR or GORD (98 GOR and 263 LPR). Presenting symptom profile, pH studies, oesophageal manometry and scintigraphy and the relationship between the above were analysed.

Results
Severe oesophageal dysmotility was more prevalent in LPR group (P = 0.037). Severe oesophageal dysmotility was strongly associated with isotope aspiration in both groups (P = 0.001). 24 per cent of patients showed evidence of pulmonary aspiration on scintigraphy. Significant correlation was established between total proximal acid on 24-hour pH monitoring and isotope aspiration in both groups (P = 0.00). Rising pharyngeal curves on scintigraphy were the strongest predictors of isotope aspiration (P = 0.00).

Conclusion
Early research on oesophageal dysmotility has suggested reduced oesophageal clearance in individuals with IOM. This selected group of patients showed a high degree of impaired oesophageal motility, which was associated with rising time-activity curves in both the upper oesophagus and pharynx. The presence of refluxate in the upper oesophagus can stimulate cough via ‘reflex’ afferent pathways and the presence of gastric contents in the pharynx can cause direct irritation to upper airways, both resulting in cough. Reduced pressures in the lower oesophageal sphincter were equally prevalent in LPR and GORD groups and therefore were not discriminatory between the clinical groups. The impairment of oesophageal clearance secondary to diminished oesophageal motility, may offer a plausible explanation for the development of symptoms via combined ‘reflux’ and ‘reflex’ pathways, allowing continued oesophageal exposure or proximal exposure to refluxate. The ROC and cluster analysis demonstrated strong predictive values and linkages between ineffective oesophageal motility and rising pharyngeal time-activity curves for the prediction of lung aspiration. This may form the basis of a new approach to the definitive diagnosis of LPR and lung aspiration. Oesophageal dysmotility is a key factor in pathophysiology of LPR. Severe impaired oesophageal motility is strongly associated with pulmonary aspiration in both LPR and GORD.

Disclosure
All authors have declared no conflicts of interest.
PS01.014: DESCRIPTION OF ACHALASIA PATIENTS IN CUBA: NINE-YEAR EXPERIENCE
Authors: Anido Vivianne , Roque González Rosalba , Brizuela Raul , Amable Tatiana , Pérez Luis , Díaz Zunilda , Luis Garcia-Menocal Jorge , Morera Maricela 
Published: September 2018

Abstract

Background
Achalasia is a primary neurodegenerative disease of the esophagus characterized by loss of function of the lower esophageal sphincter (LES) and aperistalsis of the body of the esophagus. Among the diagnostic elements, conventional or high-resolution esophageal manometry is the ‘gold standard’ for diagnosis. In this study, our objective was to investigate the epidemiology and characteristics of patients with Achalasia, seen at the CNCMA, Cuba.

Methods
A retrospective, descriptive and observational study was performed on patients with Achalasia, diagnosed through conventional esophageal manometry, from January 2006 to December 2015. The database of patients diagnosed with the disease is analyzed at the center's Motility Laboratory. Esophageal manometries were performed by the perfusion method, with Medtronic equipment, 4 register channel catheters, at 5 cm from each other, with Polygram software, from 2005 to 2008 and from then on with catheters Zynetic, Alpine, and Polygram.Net software version 4.1.1322. The consent was asked to performance the test and the scientific use of the results.

Results
332 patients were diagnosed with achalasia through manometry. More than half of patients with achalasia in this study were female, over 40 years. Patients had no proved associations with other diseases. By conventional esophageal manometry, the typical features were poor relaxation, normal basal pressure of the lower esophageal sphincter and absence of esophageal peristalsis.

Conclusion
Conventional esophageal manometry was useful to stablish the diagnostic of Achalasia, showing the typical features of the disease.

Disclosure
All authors have declared no conflicts of interest.
PS01.019: BARIUM FLUOROSCOPY AS A GOOD DIAGNOSTIC MODALITY FOR THE PATIENTS WITH LATE DIAGNOSIS OF ESOPHAGEAL ACHALASIA
Authors: Nakano Toru , Koseki Ken , Shibata Chikashi , Kamei Takashi , Ishii Tadashi 
Published: September 2018

Abstract

Background
Achalasia is a relatively rare disorder and the diagnosis would be delayed or mistaken as eating disorders like as anorexia nervosa. This study aimed to assess the diagnostic modalities to find the potential achalasia with delayed diagnosis.

Methods
Thirty-eight patients of achalasia presented to Tohoku University Hospital during 2006 to 2015 were retrospectively analyzed based on the medical records. Twenty-three patients that took less than 6 months to diagnosis (group A); 15 patients that took more than 6 months (group B) were evaluated in the duration for diagnosis, modalities and their clinical findings.

Results
No patients of group B and 16 of 21 patients of group A underwent barium study in the first 6 months after visiting to their physician (P = 0.0001). During the subsequent clinical coarse after 6 months from first visit to physician, 13 cases and 8 cases of group B were diagnosed by barium study and by endoscopic examination, respectively.

Conclusion
No obstructive finding of gastrointestinal endoscopy is insufficient to deny the possibility of achalasia. It is useful for patients with eating disorders due to unknown origin should be considered to perform the barium study to make potential achalasia apparent.

Disclosure
All authors have declared no conflicts of interest.