Short-term outcomes of enhanced recovery after surgery protocol in robotic-assisted McKeown esophagectomy for esophageal cancer: a single-center retrospective cohort study.

Background: This study aimed to evaluate the short-term outcomes of enhanced recovery after surgery (ERAS) protocol in perioperative robotic-assisted McKeown esophagectomy (RAME) among esophageal cancer patients.

Methods: For this retrospective study, all patients who had undergone RAME with esophageal cancer using ERAS protocol and conventional management strategy at the surgery center of our hospital from February 2019 to March 2022 were performed for analysis.

Results: A total of 211 patients were included.

Role of Lower Esophageal Squamous Cell Carcinoma Margin Location on Abdominal Lymph Node Metastasis Risk.

Background: Different sites of esophageal cancer are accompanied by different regional lymph node metastasis (LNM) risks. We aimed to investigate the impact of a lower tumor margin on abdominal LNM risk.

Methods: We enrolled patients who underwent esophagectomy for esophageal squamous carcinoma (ESCC) from 2014 to 2017 in West China Hospital.

Whether the start time of elective lung surgery impacts perioperative outcomes and cost?

Background: Fatigue and the long work hours of surgeons have attracted increasing concern in recent years. We aimed to explore whether starting time was associated with perioperative outcomes and cost for elective lung surgery.

Methods: A retrospective study was conducted on elective lung surgery patients at a high surgery-volume center between September 2019 and November 2019.

A New Risk Factor for Cervical Anastomotic Leakage-Role of The Relative Gastric Length in the Surgical Treatment of Esophageal Cancer.

Background: Blood supply is especially weak near the gastric fundus. Making the anastomosis in this area would increase the risk of anastomotic leakage (AL). In cervical anastomosis, the gastric conduit needs to travel through the thorax.

Surgical Treatment for Esophageal Leiomyoma: 13 Years of Experience in a High-Volume Tertiary Hospital.

Background: Esophageal leiomyoma is the most common benign tumor in the esophagus. Thoracotomy and thoracoscopy are both elective for esophageal leiomyoma enucleation. This study aimed at presenting surgical experience in our center and exploring more suitable surgical methods for different situations.

Prognostic value of node skip metastasis on esophageal cancer: A systematic review and meta-analysis.

The association between NSM and prognosis of esophageal cancer remains controversial, though several studies have been conducted drawing their own conclusion. Therefore, we firstly carried out this meta-analysis aiming to explore the association. We performed a comprehensive literature search online, including PubMed, Embase and Web of Science.

Pretreatment-assisted robot intrathoracic layered anastomosis: our exploration in Ivor-Lewis esophagectomy.

Background: Minimal invasive Ivor-Lewis esophagectomy (MIIVE) with intrathoracic esophago-gastric anastomosis (EGA) is still under exploration and the preferred technique for intrathoracic anastomosis has not been established.

Methods: We retrospectively reviewed 43 consecutive patients who underwent MIIVE using the series technique called pretreatment-assisted robot intrathoracic layered anastomosis (PRILA), performed by a single surgeon between September 2018 and December 2020. The operative outcomes were analyzed.

Safety profile of preoperative administration of low-molecular-weight heparin on minimally invasive lung cancer surgery: a randomized controlled trial.

Background: Venous thromboembolism remains a common but preventable complication for cancerous lung surgical patients. Current guidelines recommend thromboprophylaxis for lung patients at high risk of thrombosis, while a consensus about specific administration time is not reached. This study was designed to investigate the safety profile of preoperative administration of low-molecular-weight-heparin (LMWH) for lung cancer patients.

Is the routine placement of a feeding jejunostomy during esophagectomy worthwhile?-a systematic review and meta-analysis.

Background: Malnutrition dramatically increases the risk of postoperative complications and delays patient recovery. Therefore, a feeding jejunostomy tube (FJT) is routinely placed during esophagectomy to maintain the postoperative nutrition supply. However, recently published studies have questioned the need of a FJT in every esophageal cancer patient.

From McKeown to Ivor Lewis, the learning curve for thoracic lymphadenectomy over the first 100 robotic esophagectomy cases: a retrospective study.

Background: Lymphadenectomy is an essential but challenging part of the surgical treatment for esophageal cancer. However, the previously reported learning curve for robotic esophagectomy primarily focused on only one surgical approach (McKeown or Ivor Lewis). However, both approaches must be mastered by a mature robotic surgical team to deal with different clinical conditions and satisfy patients' needs.

Role of nodal skip metastasis in patients with mid-thoracic oesophageal squamous cell carcinoma: a propensity score matching study.

Objectives: Nodal skip metastasis (NSM) is a common phenomenon in mid-thoracic oesophageal squamous cell carcinoma (MT-OSCC); however, the prognostic implications of NSM in patients with MT-OSCC remain unclear.

Methods: This retrospective study enrolled 300 patients with MT-OSCC who underwent radical oesophagectomy and who had pathologically confirmed lymph node metastasis from January 2014 to December 2016. The patients were divided into 2 groups according to the presence or absence of NSM.

Predictors for the clinical benefit of anti-PD-1/PD-L1 therapy in advanced gastroesophageal cancer: a meta-analysis of clinical trials.

Background: The overall objective response rate (ORR) of published clinical trials in advanced gastroesophageal cancer patients who received anti-program-death-1 (anti-PD-1) or program-death-legend-1 (anti-PD-L1) therapy was only 10%. This ratio is far away from satisfying. It is necessary to identify patients who are more likely to benefit from the treatment.

The efficacy of ischemic conditioning in the prevention of gastroesophageal anastomotic complications: a meta-analysis.

Background: The blood supply to the gastric conduit is thought to be the most crucial factor affecting the healing of the gastroesophageal anastomosis. By selective ligation or embolization of gastric vessels, ischemic conditioning (IC) could promote the hypertrophy and neovascularization of the remaining gastric vessels. So that it could help the stomach adapt to the decline of blood supply before esophagectomy.

Preoperative dilated esophagus is associated with a high risk of intrathoracic anastomotic leakage for patients with esophageal cancer.

Background: The association between the preoperative condition of the esophagus and anastomotic leakage has seldom been studied. We observed a dominant dilation of the esophagus under barium esophagography in some esophageal cancer patients. In consideration of the larger circular stapler are applied in colorectal surgery, we wonder if larger circular stapler should be applied in these patients to fit the larger esophagus.

Fixed in the neck or pushed back into the thorax?-Impact of cervical anastomosis position on anastomosis healing.

Background: Cervical anastomotic leakage remains a great challenge for thoracic surgeons in the surgical treatment of esophageal cancer. Among the factors affecting cervical anastomosis healing, the surgical technique is the key controllable element. This study aimed to identify the risk factors of cervical anastomotic leakage after McKeown esophagectomy, especially those controllable surgical factors.

Predictive Value of Excision Repair Cross-Complementation Group 1 in the Response to Platinum-Based Chemotherapy in Esophageal Cancer: A Meta-Analysis.

Introduction: Platinum is widely used in the treatment of esophageal cancer. In clinical practice, it is significant to distinguish patients who respond to platinum from those who do not. Excision repair cross-complementation group 1 (ERCC1) is thought to be the key in the resistance to platinum.

Ergonomic thoracic port design for video-assisted thoracoscopic minimally invasive esophagectomy and lymphadenectomy: a preliminary pilot study.

Background: Video-assisted minimally invasive esophagectomy (MIE) has been widely applied in clinical practice. However, the optimal port design for thoracoscopic esophagectomy and lymphadenectomy has not been well established. Here we introduced our novel ergonomic thoracic port design as well as our novel procedures of lymphadenectomy via tissue interactive retraction and compared its effects with that of conventional port design in this pilot study.

Preoperative prognostic nutritional index shows no significant prognostic value for short-term outcomes of anastomosis-leakage patients after cancerous esophagectomy.

Background: The relationship between preoperative nutritional and immunological status and long-term outcome after cancerous esophagectomy has been investigated widely. Growing evidence also demonstrated preoperative nutritional and immunological status also affects short-term outcome after surgery for esophageal cancer. However, the relationship between preoperative nutritional and immunological status and short-term outcome of anastomosis-leakage patients after cancerous esophagectomy was scarce.

Tumor location is an independent prognostic factor of esophageal adenocarcinoma based on the eighth edition of TNM staging system in Chinese patients.

Background: Whether tumor location has any impact on the survival of esophageal adenocarcinoma patients remains unclear. Therefore, we aimed to investigate the prognostic value of tumor location for esophageal adenocarcinoma based on the eighth edition of tumor-node-metastasis (TNM) staging system in Chinese patients for the first time.

Methods: We conducted a retrospective analysis of patients undergoing esophagectomy for esophageal adenocarcinoma in our department.

Impacts of thoracoscopic surgery and high grade histologic subtypes on spread through air spaces in small stage I lung adenocarcinomas.

Objectives: Spread through air spaces (STAS) as a pattern of invasion in lung adenocarcinomas had been recognized by WHO in 2015. Moreover, STAS was associated significantly with aggressive micropapillary or solid components when presented predominant pattern in lung adenocarcinomas, which had a poor prognostic significance. Small amounts of micropapillary or solid with components could also reduce overall survival and recurrence-free survival but its impact on STAS is unknown now.

Preoperative thromboprophylactic administration of low-molecular-weight-heparin significantly decreased the risk of intraoperative bleeding compared with heparin in patients undergoing video-assisted lobectomy for lung cancer.

Background: Due to the threat from venous thromboembolism (VTE) after major thoracic surgery, especially for cancers, guidelines recommend either heparin sodium (unfractionated heparin) or low-molecular-weight-heparin (LMWH) for those patients at high risk of deep vein thrombosis (DVT). However, risk of bleeding remains a major concern for pre-operative administration of anti-coagulation agents. Therefore, this study aimed to compare the bleeding risk of preoperative administration of LMWH and heparin in patients undergoing video-assisted thoracic surgery (VATS) lobectomy for lung cancer.

Role of everolimus in the treatment of advanced neuroendocrine tumor: a meta-analysis of randomized trials.

Purpose: There are two fundamentally groups of neuroendocrine neoplasms: neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs). Target therapy plays a quite important role in the treatment of NETs. However, whether everolimus (mTOR inhibitor) could improve the overall survival (OS) of NETs is contradictory and the efficacy of the agent in NETs from specific organ is lacking analysis.

Lung Adenocarcinoma has a Higher Risk of Lymph Node Metastasis than Squamous Cell Carcinoma: A Propensity Score-Matched Analysis.

Background: Controversy still exists in which subtype of non-small-cell lung cancer [squamous cell carcinoma (SCC) or adenocarcinoma] is more likely to have lymph node (LN) metastasis. The aim of this study is to compare the pattern of LN metastasis in two cohorts of matched patients surgically treated for SCC or adenocarcinoma.

Methods: A retrospective analysis of patients undergoing lobectomy or segmentectomy with systematic lymphadenectomy without preoperative treatment for lung SCC or adenocarcinoma was conducted in this study.