bluuebunny/crossref_metadata_2025_split huggingface dataset:
606. THE CHANGES OF THORACOSCOPIC OR LAPAROSCOPIC APPROACH FOR SPONTANEOUS ESOPHAGEAL RUPTURE IN JAPAN
Authors: Yajima Satoshi , Suzuki Takashi , Shiratori Fumiaki , Yamakawa Teruki , Okubo Kazunori , Oshima Yoko , Shimada Hideaki 
Published: September 2024

Abstract

Background
The surgical treatment for esophageal rupture includes various approaches such as thoracotomy, laparotomy, thoracoscopy, and laparoscopy.
These approaches aim to: Suture the perforation site, sealing it with omentum. or esophageal resection and reconstruction. Cleanse and drain the mediastinum or thoracic cavity. Adding gastrostomy or intestinal as needed. Many reports showed the usefulness of minimally invasive surgeries. In this study, we added our cases and discussed the surgical techniques and outcomes.

Method
I searched for reported cases in PubMed and the Journal of Health Care and Society and supplemented them with my experimental cases for analysis. All reports published between 2001 and the end of 2022 were included in this study.

Results
From 2001 to 2022, there have been 15 reports (16 cases) of idiopathic esophageal rupture using arthroscopic techniques, including our cases, 14 cases in men and 3 cases in women. The ages of the patients ranged from 39 to 78 years (mean 61 years, median 61 years), and the rupture sites were the lower esophagus in 15 cases (88%) and the middle part in 2 cases (12%). The time from onset of symptoms to surgery ranged from 4 to 77 hours. The approach method was thoracoscopy in 7 cases (41%), laparoscopy in 8 cases (47%), and a combination of thoracoscopic and laparoscopy in 2 cases (12%). Complications of Clavien-Dindo classification IIIa or higher were observed in 3 patients (18%). There were two cases each of thoracoscopic and laparoscopic complications in which complications were observed. The time from arthroscopic surgery to discharge was 12-120 days (mean 36.7 days, median 30.5 days). For cases with a thoracoscopic approach, the period from surgery to discharge is 23-120 days (average 50.1 days, median 39 days), and for cases with a laparoscopic approach, the period from surgery to discharge is 12-82 days (average 30 days). days, median 21 days).

Discussion
Spontaneous esophageal rupture develops various disease patterns such as mediastinum limited type with mild symptoms and intrathoracic rupture type. There are various treatment approaches, including conservative therapy, endoscopic closure, and surgery. The laparoscopic approach seemed to reduce the length of hospital stays.

Conclusion
The surgical approach for spontaneous esophageal rupture has been changed from thoracotomy to laparoscopic surgery. The trans hiatal procedure will increase among laparoscopic surgery. Spontaneous esophageal rupture is a remarkably highly invasive disease, and we thought that a less invasive and simpler treatment would be desirable.
608. ASSOCIATION BETWEEN SYSTEMIC IMMUNE-INFLAMMATION INDEX (SII) AND THE RISK OF ALL-CAUSE, CANCER, AND NON-CANCER MORTALITY IN THE GENERAL POPULATION
Authors: Xia Peng , Wu Siyu , Liu Zhao , Li Xing , Gao Shan 
Published: September 2024

Abstract

Background
The system immune-inflammation index (SII), based on the counts of platelet, neutrophil and lymphocyte, was recognized as an accurate immunoinflammatory predictor. In order to identify the association between SII with all-cause, cancer and non-cancer mortality among general population, we conducted this prospective cohort study.

Methods
25955 participants (≥ 18 years) were included from 2005-2018 National Health and Nutrition Examination Survey (NHANES) and grouped according to the SII quartiles. The association between SII and mortality was identified by multivariate Cox regression and restricted cubic spline (RCS) analyses. Survival outcomes were assessed using Kaplan-Meier analyse.

Results
In fully adjusted model, the adjusted hazard ratio (aHR) and 95% confidence intervals (CIs) of individuals in Q4 of SII were 1.24 (1.09, 1.41) for all-cause mortality and 1.41 (1.23, 1.63) for non-cancer mortality compared with Q1. The aHR and 95% CIs in Q2 of SII were 0.70 (0.50, 0.99) and in Q3 were 0.68 (0.52, 0.87) compared with Q1 for cancer mortality. In RCS analyses, J-shaped curves were observed in the association between SII with all-cause and non-cancer mortality. Additionally, a U-shaped curve was identified between SII and cancer mortality with a threshold SII value of 445.22.

Conclusion
Therefore, our findings imply that SII can serve as a potential prognosis indicator among general population. Elevated SII is associated with higher all-cause and non-cancer mortality. Besides, both lower and higher SII can serve as predictive factors for cancer mortality.
612. THE UTILITY OF H ANASTOMOSIS IN INFLATABLE MEDIASTINOSCOPE-ASSISTED TRANSHIATAL ESOPHAGECTOMY FOR ESOPHAGEAL CANCER
Authors: Wu Na , Hu Yang 
Published: September 2024

Abstract

Objectives
In this article we present a novel technique to improve the outcome of mediastinoscope-assisted transhiatal esophagectomy (MATHE).

Methods
H anastomosis is derived from intussusceptive anastomosis, which reinforced the barrier from the alimentary canal cavity to the mediastinum and fromed an one-direction valve to preventing gastroesophageal reflux. H anastomosis improved the blood supply of gastric tube by reduce the thickness of intussuscepted tissue to adapt to the narrow esophageal bed in MATHE.

Results
Anastomotic leakage, gastroesophageal reflux and dysphagia were well controlled.

Conclusions
The good outcomes of H anastomosis in MATHE need further validation.
https://1drv.ms/v/s!AmCqlJJZqDPDjRjAwgLApB_mkRVp?e=b8Iflp
614. LAPAROSCOPIC RE DO FUNDOPLICATION
Authors: Parthasarathi R , Cumar Bharath , Ramesh N 
Published: September 2024

Abstract

Background
Laparoscopic fundoplication though an effective form of therapy for patients with refractory gastroesophageal reflux disease, can fail due to poor patient selection or compromised surgical technique. Re do laparoscopic fundoplication for failed anti reflux surgery is a challenging task prone to further failures if not properly done.

Methods
Retrospective analysis of consecutive patients who underwent laparoscopic redo fundoplication in a tertiary care center between January 2012 and March 2022.

Results
There were a total of 24 patients that underwent redo fundoplication during the study period. Wrap migration was noted in 8 (33.3%) patients while the wrap was too tight which led to dysphagia in 5
(20.8%) patients. Two patients had previously undergone laparoscopic redo fundoplication while one patient initially underwent open Nissen’s fundoplication. All the patients were managed successfully laparoscopically without any conversion. The median time interval between the first surgery and the redo operation was 8 months (3 months to 12 years). Symptomatic improvement was observed in 20 (83.3%) while 4 (16.7%) patients continued to have symptoms.

Conclusion
Laparoscopic redo fundoplication can yield satisfactory results in patients after initially failed anti reflux surgery when performed in experienced centers. Proper case selection and meticulous surgical technique to address the primary cause of failure is paramount.
622. COMPARISON OF ROBOT-ASSISTED MINIMALLY INVASIVE ESOPHAGECTOMY WITH CONVENTIONAL MINIMALLY INVASIVE ESOPHAGECTOMY FOR ESOPHAGEAL CANCER: A MULTI-INSTITUTIONAL COHORT STUDY
Authors: Tsunoda Shigeru , Obama Kazutaka , Hosogi Hisahiro , Kanaya Seiichiro , Matsufuji Shohei , Noshiro Hirokazu , Shibasaki Susumu , Suda Koichi , Uyama Ichiro , Ohuchida Kenoki , Okabe Hiroshi , Nishigori Tatsuto 
Published: September 2024

Abstract

Background
The Japanese public insurance system approved robot-assisted minimally invasive esophagectomy (RAMIE) for esophageal cancer in 2018. Since then, an increasing number of RAMIE has been performed every year. However, it is unclear whether RAMIE is more beneficial than conventional minimally invasive esophagectomy (MIE) in terms of short-term and long-term outcomes.

Methods
A total of 396 patients (RAMIE, 145; MIE, 251) with resectable esophageal cancer who underwent esophagectomy between 2016 and 2019 at 6 institutions were included. A propensity score matching analysis was performed to compare the short-term outcome. Two-stage esophagectomy, salvage surgery, and palliative resection were excluded.
Individual propensity scores were calculated based on the following 15 variables: age, sex, body mass index, American Society of Anesthesiologists Physical Status (ASA-PS), hemodialysis, oral steroid use, obstructive pulmonary disease, histology, tumor location, clinical T, N, M classification, preoperative therapy, field of lymphadenectomy, and organ used for reconstruction.

Results
After matching 272 patients were analyzed. RAMIE took the significantly longer operating time (629min; 570min, p=0.0005), but the amount of blood loss (90g; 84g), number of harvested mediastinal nodes (24; 25), and in-hospital mortality (1.5%; 0.7%) were comparable. RAMIE group showed a trend of less severe post-operative morbidity (Clavien–Dindo grade III or higher) (18%; 27%) and significant reduction of recurrent laryngeal nerve palsy (23%; 35%, p=0.046).
The 5-year overall and relapse-free survival in the RAMIE and MIE groups were 65%; 61% [hazard ratio (HR), 0.77; 95% CI: 0.51, 1.17], and 61%; 51% (HR, 0.73; 95% CI: 0.51, 1.06), respectively.

Conclusion
RAMIE was safely performed even during the early period of its application. Despite the longer operating time, RAMIE would be a promising alternative to MIE, with a better trend of short- and long-term outcomes, including a significantly lower incidence of postoperative recurrent laryngeal nerve palsy.
633. DOES SARCOPENIA PREDICT NEOADJUVANT CHEMOTHERAPY TOXICITY IN OESOPHAGEAL ADENOCARCINOMA PATIENTS?
Authors: Dayanamby Abbienaya , Chmelo Jakub , Convill James , Samake Maurice , Petrides George , Bradshaw Alexander , Phillips Alexander W 
Published: September 2024

Abstract

Background
Sarcopenia, defined as the loss of muscle mass and function, is associated with a high risk of adverse outcomes in the cancer population. Radiologically defined sarcopenia has been linked to both short- and long-term outcomes after oesophagectomy for cancer. Neoadjuvant treatment plays a crucial role in the treatment of locally advanced oesophagogastric cancer. It is not fully clear whether patients with low muscle mass are more prone to sustaining acute chemotherapy toxicities during neoadjuvant chemotherapy (NAC) prior to oesophagectomy, especially when ECX or FLOT chemotherapy regimens are used.

Methods
Patients undergoing NAC and oesophagectomy between January 2016 and December 2022 had their skeletal muscle index analysed (SMI) at the time of initial staging. SMI was computed from staging CT scan slices as the lean muscle mass at the level of the third lumbar vertebra and the height of the patient. Patients were then divided into two categories depending on whether their NAC was completed fully (FLOT four cycles, ECX three cycles) or whether NAC treatment was incomplete. The Mann-Whitney U test was used to statistically test the hypothesis of any difference in SMI between these two groups.

Results
There were 208 patients included in this study. 109 patients had ECX and 90 patients had FLOT. Fourteen patients (6.7%) did not complete NAC treatment fully but progressed to oesophagectomy. The median (IQR) SMI of patients who did not complete NAC treatment was 46.54 cm2/m2 (43.40-51.32) compared to 50.87 cm2/m2 (45.88-57.33) for those who received all prescribed NAC cycles (p=0.026).

Conclusion
This study demonstrated that patients with higher SMI are better equipped to withstand the side effects of NAC and complete this treatment. It appears that strategies to improve sarcopenia before or during NAC are needed. Prehabilitation might be one of these strategies, and therefore, the effect of various prehabilitation regimens on sarcopenia needs to be further explored.
635. FLEXIBLE ENDOSCOPIC SEPTUM DIVISION FOR ZENKER’S DIVERTICULUM: A SINGLE CENTRE EXPERIENCE
Authors: Mandello Marika , Sacco Michele , Massella Arianna , Cerofolini Angelo , Guerzoni Giacomo , Cuce' Federica , De Manzoni Giovanni , Giacopuzzi Simone 
Published: September 2024

Abstract

Background
Zenker diverticulum (ZD) is a pseudodiverticulum of the Killian’s triangle and usually affects males in the 6th-9th decade of life. Symptoms include dysphagia, regurgitation, chronic cough, aspiration, halitosis, and weight loss. The treatment of symptomatic ZD is operative and can surgical or endoscopic. Flexible endoscopic septum division is becoming a prominent treatment option for Zenker's diverticulum (ZD). We report our experience with Flexible endoscopic septum division.

Methods
Data on all consecutive patients that underwent flexible endoscopic treatment for symptomatic Zenker’s diverticulum from February 2021 to December 2023 were retrieved. All patients were diagnosed trough both barium esophagogram and EGDS. All procedures were performed in our centre by the same endoscopist. Dysphagia, regurgitation, and respiratory symptoms severity before the procedure were graded with the Kothari-Haber Scoring System (KH SS). Complications, LOS, symptoms scores and recurrences were recorded. Follow up was performed trough clinical and radiological evaluation.

Results
19 patients were included, 16 (84%) men, mean age 77.2 years (53-79). Pre-operative mean symptoms score was 6.1 (4-9). The pre-operative mean pouch size was 4,16 cm (range 2,3-6). Median length of stay was 3 days (2-18). One patient had an oesophageal leak that was managed endoscopically with clip positioning, nasogastric tube, fasting, and antibiotics, with satisfactory long term clinical outcome. No other complications were reported. All patients reported significant symptom improvement, median post-operative symptoms score was 0,3 (0-3).
Mild relapsing symptoms were present in two patients (10,5%), at 12 and 35 months. Both patients refused further treatments for recurrence.

Conclusions
Treatment of ZD with flexible endoscopic septum division is a feasible, safe and effective option with satisfactory long-term results.
641. COMPARISON OF SURGICAL TREATMENTS FOR GASTROESOPHAGEAL REFLUX IN SYSTEMIC SCLEROSIS
Authors: Szachnowicz Sergio , Ferros Lucas , Friedmann Ilan , Duarte Andre , Bianchi Edno , Seguro Francisco , Sallum Rubens , Júnior Ulysses Ribeiro 
Published: September 2024

Abstract

Background
This study proposes to compare the results of refractory gastroesophageal reflux disease (GERD) in patients with Systemic sclerosis, aiming to compare the results of different surgical approaches.

Methods
44 patients are presented, followed between 2005 and 2024, diagnosed with Systemic Sclerosis and referred to our service. Just 7 patients were submitted to surgical treatment of GERD. Three different were done: partial fundoplication, Roux-en-Y gastroplasty, and Esophagectomy.

Results
Considering the 44 patients, just 15,9 % were operated. Two underwent partial fundoplication, 2 esophagectomies, and 3 gastric bypasses. The patients submitted to esophagectomy had delayed or incomplete esophagic emptying, and the patients who underwent gastric bypass, even with total aperistalsis showed good esophagic emptying during a barium swallow. Only patients without aperistalsis were offered partial fundoplication. We had no mortality, and the morbidity was 33% in gastric Bypass, with no morbidity in the fundoplication and esophagectomy group. The patients submitted to bypass presented better QOL and reflux control.

Conclusion
The surgical approach to the treatment of GERD in Systemic sclerosis is recommended just in selective cases and should be tailored concerning the clinical conditions and the esophagus emptying of each patient.
765. PATTERNS, TIMING, AND SURVIVAL OF RECURRENCE FOLLOWING SURGERY FOR ESOPHAGEAL ADENOCARCINOMA IN THE EUROPEAN MULTICENTRE ENSURE STUDY
Authors: Goense Lucas , Elliott Jessie , Markar Sheraz , Klevebro Fredrik , Johar Asif , Mantziari Styliani , Lagergren Pernilla , Zaninotto Giovanni , van Hillegersberg Richard , van Berge Henegouwen Mark , Nilsson Magnus , Hanna George , Reynolds John 
Published: September 2024

Abstract

Background
After surgery for esophageal cancer approximately half of patients will develop disease recurrence. A more accurate and detailed understanding of the pattern, timing, treatment and prognosis of initial recurrence sites can guide improvements in surveillance and therapy. Therefore, the aim of this study was to accurately describe the pattern and timing of esophageal cancer recurrence, and to assess the distinct survival patterns of these recurrence locations.

Methods
This study included all patients who underwent surgical resection for esophageal and junctional adenocarcinoma registered in the ENSURE study. ENSURE was an international multicenter study of consecutive patients undergoing surgery for esophageal and esophagogastric junction cancers between 2009 and 2015 across 20 centers in Europe and Canada (NCT03461341). The first recurrence site was recorded and recurrence-free survival (RFS) was estimated using Kaplan-Meier curves. Sites of first recurrence were stratified into different groups and survival outcomes post recurrence detection were estimated using Kaplan-Meier curves.

Results
Of 3397 eligible patients, 1310 patients had disease recurrence with comprehensive follow-up data available (median RFS of 12.1 months). First recurrence was detected at multiple distant sites (n=469; 37.3%) or at a single distant site (n=463; 33.7%), while isolated local recurrence occurred in 189 (14.4%) patients. Liver-only recurrence occurred significantly earlier (median 9.0 months), while lung-only (15.2 months) and local-only occurred later (17.8 months). Patients with multiple-sites and liver-only recurrence had significant worse median post recurrence survival (7.4 and 8.3 months, respectively) when compared with lung- or local-only recurrence (10.4 and 15.9 months, respectively).

Conclusion
This study demonstrates that specific recurrence locations of esophageal cancer possess distinct RFS curves. Furthermore, specific recurrence locations result in different post recurrence survival outcomes. This information can help guide improvements in surveillance after esophageal cancer surgery and decisions regarding treatment of esophageal cancer recurrence.
776. THREE-FIELD LYMPHADENECTOMY IN ESOPHAGEAL CANCER: EXPERIENCE OF A PORTUGUESE TERTIARY CENTER
Authors: do Carmo Girão Maria , Silva Francisca Brito , Cabral Francisco , Ramos Paulo , Monteiro Cecília , Casaca Rui 
Published: September 2024

Abstract

Background
The American Joint Committee for Cancer (AJCC) and the Japanese Esophagus Society (JES) differ in the N classification for esophageal cancer, with the former considering the presence of disease in the supraclavicular lymph nodes as M1, and the latter classifying it as loco-regional disease in thoracic esophageal tumors. Patients who would be excluded from a curative intent treatment strategy by the AJCC classification may be candidates for surgery with lymphadenectomy of nodal groups 101 and 104 (JES).
Our goal is to understand the impact of three-field lymphadenectomy on morbidity, loco-regional control and overall survival in patients with esophageal cancer.

Methods
A retrospective cohort study was conducted using data from a prospective database from a single center, which included all consecutive patients undergoing esophagectomy for cancer with either two-field total thoracic lymphadenectomy or three-field lymphadenectomy, between January 2019 and December 2023.
Three-field lymphadenectomy was performed for clinical supraclavicular and recurrent nerve nodal involvement and for proximal third tumors.
We assessed the morbidity and mortality of both types of surgery, and loco-regional and distant recurrence and overall survival for both groups.

Results
Of the 279 esophagectomies for cancer, 137 were included for analysis. The median age was 65 years, with 84% males. 58,4% had squamous cell carcinoma and 41,6% adenocarcinoma. 34.3% of the patients had a 3-field lymphadenectomy, 27,7% of these for supraclavicular N+ and 34% for recurrent nerve N+.

Conclusion
In this large single-center cohort, patients with significant lymph node involvement, treated with esophagectomy and three-field lymphadenectomy, demonstrated comparable loco-regional control and overall survival to more favorable cases, with no statistically significant increase in morbidity and mortality.
816. BRONCHIAL INJURY AND REPAIR DURING MINIMALLY INVASIVE ESOPHAGECTOMY
Authors: Harris Caleb 
Published: September 2024

Abstract

Background
Video Assisted Thoracoscopy (VATS) is the preferred approach to Esophagectomy thanks to the improved short term outcomes without any compromise on the oncological outcomes. VATS Esophagectomy is technically difficult and has a steep learning curve, with several potential complications.

Description
This is the video of a patient with early esophageal cancer (T1N0M0) who underwent VATS esophagectomy in the semi-prone position with capnothorax. There was an inadvertent injury to the membranous wall of the left bronchus which was sutured using monofilament absorbable sutures. The omentum was wrapped around and sutured to the anterior wall of the stomach tube, which reinforced the sutures once it was pulled up into the thorax. Patient had an uneventful postoperative recovery.

Importance
This video, apart from stressing on the need for careful dissection around the bronchial tree, shows that such an injury can be managed with minimal invasive techniques.
https://1drv.ms/v/s!AmL6SI2dDeQVh9AzGMuncYi8GT3nIQ?e=IcjfNd
Investigating the Impact of IL-6 and CXCL8 on Neurodegeneration and Cognitive Decline in Alzheimer Disease
Authors: Jin Dongdong , Zhang Min , Shi Lei , Liu Hengfang 
Published: September 2024

Abstract

Background
Alzheimer disease (AD) is a progressive neurodegenerative disorder primarily affecting the elderly, characterized by severe cognitive impairment and memory loss. Emerging evidence suggests that neuroinflammation plays a significant role in AD pathogenesis, with cytokines like interleukin-6 (IL-6) and C-X-C motif chemokine ligand 8 (CXCL8) contributing to the disease progression.

Methods
We utilized Gene Expression Omnibus datasets to identify IL-6 and CXCL8 as pivotal inflammatory markers in AD. In vitro experiments were conducted using SK-N-BE(2)-M17 and THP-1 cell lines treated with IL-6 and CXCL8 to model AD. Additionally, in vivo tests on Amyloid Precursor Protein/Presenilin 1 (APP/PS1) AD mouse models were performed to assess the impact of these cytokines on cognitive functions and brain pathology.

Results
The results indicated a significant decrease in cell viability, increased apoptosis, and elevated inflammatory factor secretion following IL-6 and CXCL8 treatment in vitro. In vivo, AD mouse models treated with these cytokines exhibited exacerbated emotional distress, decreased social interaction, impaired cognitive functions, and increased amyloid protein deposition in neural tissues.

Conclusions
The study highlights the detrimental effects of IL-6 and CXCL8 on neuronal health and cognitive functions in AD. These findings suggest that targeting these cytokines could offer potential therapeutic interventions for improving patient outcomes in Alzheimer disease.