Pub Date : 2024-03-07DOI: 10.1177/26345161241237521
Christopher J. Lee, Timothy M. Farrell, Evan S. Dellon
The relationship between eosinophilic esophagitis (EoE) and gastroesophageal reflux disease (GERD) is complex, and there are scant data about the role of fundoplication when GERD/EoE overlap. We aimed to describe treatment outcomes of patients with GERD/EoE overlap undergoing antireflux surgery. We conducted a retrospective cohort study of patients with overlapping EoE and GERD who had undergone laparoscopic fundoplications. Patient demographics, clinical characteristics, EoE history, and procedural/surgical data were extracted from the medical record. Endoscopic and histologic responses were assessed for pre- and post-operative endoscopies. We identified 10 patients with GERD/EoE overlap who underwent antireflux surgery, and 9 patients underwent post-operative repeat EGD. All patients had heartburn and regurgitation symptoms that were refractory to PPI and/or persistent erosive disease, and also demonstrated signs/symptoms of EoE such as dysphagia (80%), food impaction (60%), fibrostenotic disease requiring dilation (70%), and lack of symptom or histologic response to topical steroids (70%). Patients demonstrated expected improvements in erosive esophagitis and hiatal hernia. The peak eosinophil count improved from 47.1 ± 35.9 eos/hpf to 7.8 ± 12.3 eos/hpf ( P = .02). Total EREFS score decreased from 3.0 ± 2.2 to 1.2 ± 2.3 ( P = .009). Patients who have GERD/EoE overlap can have endoscopic and histologic improvement in both conditions after fundoplication. This implies that in a subset of patients, GERD may drive an EoE response, and this must be recognized for successful treatment.
{"title":"Treatment Outcomes of Patients With Overlapping Eosinophilic Esophagitis and Gastroesophageal Reflux Disease After Antireflux Surgery","authors":"Christopher J. Lee, Timothy M. Farrell, Evan S. Dellon","doi":"10.1177/26345161241237521","DOIUrl":"https://doi.org/10.1177/26345161241237521","url":null,"abstract":"The relationship between eosinophilic esophagitis (EoE) and gastroesophageal reflux disease (GERD) is complex, and there are scant data about the role of fundoplication when GERD/EoE overlap. We aimed to describe treatment outcomes of patients with GERD/EoE overlap undergoing antireflux surgery. We conducted a retrospective cohort study of patients with overlapping EoE and GERD who had undergone laparoscopic fundoplications. Patient demographics, clinical characteristics, EoE history, and procedural/surgical data were extracted from the medical record. Endoscopic and histologic responses were assessed for pre- and post-operative endoscopies. We identified 10 patients with GERD/EoE overlap who underwent antireflux surgery, and 9 patients underwent post-operative repeat EGD. All patients had heartburn and regurgitation symptoms that were refractory to PPI and/or persistent erosive disease, and also demonstrated signs/symptoms of EoE such as dysphagia (80%), food impaction (60%), fibrostenotic disease requiring dilation (70%), and lack of symptom or histologic response to topical steroids (70%). Patients demonstrated expected improvements in erosive esophagitis and hiatal hernia. The peak eosinophil count improved from 47.1 ± 35.9 eos/hpf to 7.8 ± 12.3 eos/hpf ( P = .02). Total EREFS score decreased from 3.0 ± 2.2 to 1.2 ± 2.3 ( P = .009). Patients who have GERD/EoE overlap can have endoscopic and histologic improvement in both conditions after fundoplication. This implies that in a subset of patients, GERD may drive an EoE response, and this must be recognized for successful treatment.","PeriodicalId":508891,"journal":{"name":"Foregut: The Journal of the American Foregut Society","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140260631","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}
Pub Date : 2024-03-01DOI: 10.1177/26345161241229975
Virginia R. Litle
{"title":"Squamous Cell Carcinoma—Screen and Detect to Endoscopically Resect","authors":"Virginia R. Litle","doi":"10.1177/26345161241229975","DOIUrl":"https://doi.org/10.1177/26345161241229975","url":null,"abstract":"","PeriodicalId":508891,"journal":{"name":"Foregut: The Journal of the American Foregut Society","volume":"11 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140269659","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}
Pub Date : 2024-03-01DOI: 10.1177/26345161241230714
{"title":"Thank You to All Our 2023 Reviewers","authors":"","doi":"10.1177/26345161241230714","DOIUrl":"https://doi.org/10.1177/26345161241230714","url":null,"abstract":"","PeriodicalId":508891,"journal":{"name":"Foregut: The Journal of the American Foregut Society","volume":"29 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140269269","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}
Pub Date : 2024-02-12DOI: 10.1177/26345161241230940
Stefano Siboni, Marco Sozzi, Alessia Kersik, A. Lovece, P. Milito, Fedra Menikou, Luigi Bonavina, Caterina Froiio, Daniele Bernardi, E. Asti
Gastroesophageal reflux disease (GERD) is usually associated with disruption of the esophagogastric junction (EGJ). The endoscopic Hill classification has proven to be inadequate to assess EGJ integrity. Recently, the American Foregut Society (AFS) developed an endoscopic classification focused on hiatal hernia (L), hiatal opening (D), and the flap valve (F). While pH-monitoring remains the gold standard for the diagnosis of GERD, high-resolution manometry (HRM) can assess EGJ anatomy and competency. Aim of this study is to validate the AFS classification in patients with suspected GERD assessing its accuracy in predicting EGJ disruption and pathologic reflux. We prospectively enrolled patients with suspected GERD who underwent upper endoscopy, HRM and pH-study between November 2022 and March 2023. Demographic and clinical data were analyzed. The efficacy of the AFS classification in predicting GERD (acid exposure time, AET > 6%) was assessed. Each component of the classification was compared with the corresponding HRM variable. Among 56 patients (48% men, BMI 23.5 kg/m2, age 43 years), an AET > 6% was found in 22 (39%), and in 0% of patients with AFS grade I, 5.9% with grade II, 52% with grade III and 77.8% with grade IV ( P < .001). The L component effectively predicted the EGJ type, the D the EGJ-Contractile Integral, while the absence of the flap valve was related to a positive Straight Leg Raise maneuver. The new grading system is able to stratify patients with pathologic GERD. Moreover, the single components of the AFS classification are associated with manometric markers of EGJ disruption.
{"title":"Does the American Foregut Society Endoscopic Classification of Esophago-gastric Junction Integrity Predict Acid Reflux and Esophago-gastric Junction Disruption?","authors":"Stefano Siboni, Marco Sozzi, Alessia Kersik, A. Lovece, P. Milito, Fedra Menikou, Luigi Bonavina, Caterina Froiio, Daniele Bernardi, E. Asti","doi":"10.1177/26345161241230940","DOIUrl":"https://doi.org/10.1177/26345161241230940","url":null,"abstract":"Gastroesophageal reflux disease (GERD) is usually associated with disruption of the esophagogastric junction (EGJ). The endoscopic Hill classification has proven to be inadequate to assess EGJ integrity. Recently, the American Foregut Society (AFS) developed an endoscopic classification focused on hiatal hernia (L), hiatal opening (D), and the flap valve (F). While pH-monitoring remains the gold standard for the diagnosis of GERD, high-resolution manometry (HRM) can assess EGJ anatomy and competency. Aim of this study is to validate the AFS classification in patients with suspected GERD assessing its accuracy in predicting EGJ disruption and pathologic reflux. We prospectively enrolled patients with suspected GERD who underwent upper endoscopy, HRM and pH-study between November 2022 and March 2023. Demographic and clinical data were analyzed. The efficacy of the AFS classification in predicting GERD (acid exposure time, AET > 6%) was assessed. Each component of the classification was compared with the corresponding HRM variable. Among 56 patients (48% men, BMI 23.5 kg/m2, age 43 years), an AET > 6% was found in 22 (39%), and in 0% of patients with AFS grade I, 5.9% with grade II, 52% with grade III and 77.8% with grade IV ( P < .001). The L component effectively predicted the EGJ type, the D the EGJ-Contractile Integral, while the absence of the flap valve was related to a positive Straight Leg Raise maneuver. The new grading system is able to stratify patients with pathologic GERD. Moreover, the single components of the AFS classification are associated with manometric markers of EGJ disruption.","PeriodicalId":508891,"journal":{"name":"Foregut: The Journal of the American Foregut Society","volume":"41 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139782499","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}
Pub Date : 2024-02-12DOI: 10.1177/26345161241230940
Stefano Siboni, Marco Sozzi, Alessia Kersik, A. Lovece, P. Milito, Fedra Menikou, Luigi Bonavina, Caterina Froiio, Daniele Bernardi, E. Asti
Gastroesophageal reflux disease (GERD) is usually associated with disruption of the esophagogastric junction (EGJ). The endoscopic Hill classification has proven to be inadequate to assess EGJ integrity. Recently, the American Foregut Society (AFS) developed an endoscopic classification focused on hiatal hernia (L), hiatal opening (D), and the flap valve (F). While pH-monitoring remains the gold standard for the diagnosis of GERD, high-resolution manometry (HRM) can assess EGJ anatomy and competency. Aim of this study is to validate the AFS classification in patients with suspected GERD assessing its accuracy in predicting EGJ disruption and pathologic reflux. We prospectively enrolled patients with suspected GERD who underwent upper endoscopy, HRM and pH-study between November 2022 and March 2023. Demographic and clinical data were analyzed. The efficacy of the AFS classification in predicting GERD (acid exposure time, AET > 6%) was assessed. Each component of the classification was compared with the corresponding HRM variable. Among 56 patients (48% men, BMI 23.5 kg/m2, age 43 years), an AET > 6% was found in 22 (39%), and in 0% of patients with AFS grade I, 5.9% with grade II, 52% with grade III and 77.8% with grade IV ( P < .001). The L component effectively predicted the EGJ type, the D the EGJ-Contractile Integral, while the absence of the flap valve was related to a positive Straight Leg Raise maneuver. The new grading system is able to stratify patients with pathologic GERD. Moreover, the single components of the AFS classification are associated with manometric markers of EGJ disruption.
{"title":"Does the American Foregut Society Endoscopic Classification of Esophago-gastric Junction Integrity Predict Acid Reflux and Esophago-gastric Junction Disruption?","authors":"Stefano Siboni, Marco Sozzi, Alessia Kersik, A. Lovece, P. Milito, Fedra Menikou, Luigi Bonavina, Caterina Froiio, Daniele Bernardi, E. Asti","doi":"10.1177/26345161241230940","DOIUrl":"https://doi.org/10.1177/26345161241230940","url":null,"abstract":"Gastroesophageal reflux disease (GERD) is usually associated with disruption of the esophagogastric junction (EGJ). The endoscopic Hill classification has proven to be inadequate to assess EGJ integrity. Recently, the American Foregut Society (AFS) developed an endoscopic classification focused on hiatal hernia (L), hiatal opening (D), and the flap valve (F). While pH-monitoring remains the gold standard for the diagnosis of GERD, high-resolution manometry (HRM) can assess EGJ anatomy and competency. Aim of this study is to validate the AFS classification in patients with suspected GERD assessing its accuracy in predicting EGJ disruption and pathologic reflux. We prospectively enrolled patients with suspected GERD who underwent upper endoscopy, HRM and pH-study between November 2022 and March 2023. Demographic and clinical data were analyzed. The efficacy of the AFS classification in predicting GERD (acid exposure time, AET > 6%) was assessed. Each component of the classification was compared with the corresponding HRM variable. Among 56 patients (48% men, BMI 23.5 kg/m2, age 43 years), an AET > 6% was found in 22 (39%), and in 0% of patients with AFS grade I, 5.9% with grade II, 52% with grade III and 77.8% with grade IV ( P < .001). The L component effectively predicted the EGJ type, the D the EGJ-Contractile Integral, while the absence of the flap valve was related to a positive Straight Leg Raise maneuver. The new grading system is able to stratify patients with pathologic GERD. Moreover, the single components of the AFS classification are associated with manometric markers of EGJ disruption.","PeriodicalId":508891,"journal":{"name":"Foregut: The Journal of the American Foregut Society","volume":"86 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139842208","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}
Pub Date : 2024-02-08DOI: 10.1177/26345161241231765
Fernando A. M. Herbella, V. Velanovich, Brant Oelschlager, Shahin Ayazi, Sven Eriksson, Blair Jobe, Renato Salvador, Ory Wiesel, F. Schlottmann, Marco G. Patti, Italo Braghetto, Atilla Dubecz, Anne Lidor, Donald E. Low
The outcomes for sliding and paraesophageal hiatal hernias (PHH) are jointly reported. By combining outcomes of sliding hernia and PHH repair, surgeons are conflating the outcomes of surgical management for GERD with the outcomes of PHH repair. PHH is a distinct clinical entity from sliding hernia, requiring a more complex operation with higher risk of complications and, ultimately, comparatively diminished outcomes. The practice of combining PHH and sliding hernia surgical data confounds the true outcomes of ARS and contributes to misconceptions that reduce referral rates. Current and future research assessments must be based on accurate discrimination between the 2 anatomic presentations. Surgeons have a responsibility to ensure this distinction is clearly drawn when disseminating their ARS outcomes.
滑动性食管裂孔疝和食管旁食管裂孔疝（PHH）的治疗结果是联合报告的。通过合并滑动疝和 PHH 修复的结果，外科医生将胃食管反流手术治疗的结果与 PHH 修复的结果混为一谈。PHH 与滑动疝是不同的临床实体，需要进行更复杂的手术，并发症风险更高，最终结果也相对较差。将 PHH 和滑动疝手术数据合并的做法混淆了 ARS 的真实结果，造成误解，降低了转诊率。当前和未来的研究评估必须基于对两种解剖学表现的准确区分。外科医生有责任确保在发布 ARS 结果时明确区分这两种情况。
{"title":"Sliding and Paraesophageal Hiatal Hernias are Distinct Diseases: Surgeons are Responsible for Delineating the Differences","authors":"Fernando A. M. Herbella, V. Velanovich, Brant Oelschlager, Shahin Ayazi, Sven Eriksson, Blair Jobe, Renato Salvador, Ory Wiesel, F. Schlottmann, Marco G. Patti, Italo Braghetto, Atilla Dubecz, Anne Lidor, Donald E. Low","doi":"10.1177/26345161241231765","DOIUrl":"https://doi.org/10.1177/26345161241231765","url":null,"abstract":"The outcomes for sliding and paraesophageal hiatal hernias (PHH) are jointly reported. By combining outcomes of sliding hernia and PHH repair, surgeons are conflating the outcomes of surgical management for GERD with the outcomes of PHH repair. PHH is a distinct clinical entity from sliding hernia, requiring a more complex operation with higher risk of complications and, ultimately, comparatively diminished outcomes. The practice of combining PHH and sliding hernia surgical data confounds the true outcomes of ARS and contributes to misconceptions that reduce referral rates. Current and future research assessments must be based on accurate discrimination between the 2 anatomic presentations. Surgeons have a responsibility to ensure this distinction is clearly drawn when disseminating their ARS outcomes.","PeriodicalId":508891,"journal":{"name":"Foregut: The Journal of the American Foregut Society","volume":"284 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139852714","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}
Pub Date : 2024-02-08DOI: 10.1177/26345161241231765
Fernando A. M. Herbella, V. Velanovich, Brant Oelschlager, Shahin Ayazi, Sven Eriksson, Blair Jobe, Renato Salvador, Ory Wiesel, F. Schlottmann, Marco G. Patti, Italo Braghetto, Atilla Dubecz, Anne Lidor, Donald E. Low
The outcomes for sliding and paraesophageal hiatal hernias (PHH) are jointly reported. By combining outcomes of sliding hernia and PHH repair, surgeons are conflating the outcomes of surgical management for GERD with the outcomes of PHH repair. PHH is a distinct clinical entity from sliding hernia, requiring a more complex operation with higher risk of complications and, ultimately, comparatively diminished outcomes. The practice of combining PHH and sliding hernia surgical data confounds the true outcomes of ARS and contributes to misconceptions that reduce referral rates. Current and future research assessments must be based on accurate discrimination between the 2 anatomic presentations. Surgeons have a responsibility to ensure this distinction is clearly drawn when disseminating their ARS outcomes.
滑动性食管裂孔疝和食管旁食管裂孔疝（PHH）的治疗结果是联合报告的。通过合并滑动疝和 PHH 修复的结果，外科医生将胃食管反流手术治疗的结果与 PHH 修复的结果混为一谈。PHH 与滑动疝是不同的临床实体，需要进行更复杂的手术，并发症风险更高，最终结果也相对较差。将 PHH 和滑动疝手术数据合并的做法混淆了 ARS 的真实结果，造成误解，降低了转诊率。当前和未来的研究评估必须基于对两种解剖学表现的准确区分。外科医生有责任确保在发布 ARS 结果时明确区分这两种情况。
{"title":"Sliding and Paraesophageal Hiatal Hernias are Distinct Diseases: Surgeons are Responsible for Delineating the Differences","authors":"Fernando A. M. Herbella, V. Velanovich, Brant Oelschlager, Shahin Ayazi, Sven Eriksson, Blair Jobe, Renato Salvador, Ory Wiesel, F. Schlottmann, Marco G. Patti, Italo Braghetto, Atilla Dubecz, Anne Lidor, Donald E. Low","doi":"10.1177/26345161241231765","DOIUrl":"https://doi.org/10.1177/26345161241231765","url":null,"abstract":"The outcomes for sliding and paraesophageal hiatal hernias (PHH) are jointly reported. By combining outcomes of sliding hernia and PHH repair, surgeons are conflating the outcomes of surgical management for GERD with the outcomes of PHH repair. PHH is a distinct clinical entity from sliding hernia, requiring a more complex operation with higher risk of complications and, ultimately, comparatively diminished outcomes. The practice of combining PHH and sliding hernia surgical data confounds the true outcomes of ARS and contributes to misconceptions that reduce referral rates. Current and future research assessments must be based on accurate discrimination between the 2 anatomic presentations. Surgeons have a responsibility to ensure this distinction is clearly drawn when disseminating their ARS outcomes.","PeriodicalId":508891,"journal":{"name":"Foregut: The Journal of the American Foregut Society","volume":" 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139792620","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}
Pub Date : 2024-01-06DOI: 10.1177/26345161231223907
Ian Y. H. Wong, S. Law
Squamous dysplasia precedes invasive squamous cell carcinoma of the esophagus, but there is limited evidence on its surgical management. The “field change effect” further complicates matters, causing multifocal or second primary neoplasms in the esophagus and upper aerodigestive tract. While endoscopic procedures are the primary treatment, surgical resection, either alone or in combination with endoscopy, must be considered given the extent of the disease and organ involvement. This chapter summarizes multifocal squamous dysplasia scenarios and highlights the role of esophagectomy or surgical resection.
{"title":"Management of Multifocal Squamous Dysplasia: Role of Esophagectomy","authors":"Ian Y. H. Wong, S. Law","doi":"10.1177/26345161231223907","DOIUrl":"https://doi.org/10.1177/26345161231223907","url":null,"abstract":"Squamous dysplasia precedes invasive squamous cell carcinoma of the esophagus, but there is limited evidence on its surgical management. The “field change effect” further complicates matters, causing multifocal or second primary neoplasms in the esophagus and upper aerodigestive tract. While endoscopic procedures are the primary treatment, surgical resection, either alone or in combination with endoscopy, must be considered given the extent of the disease and organ involvement. This chapter summarizes multifocal squamous dysplasia scenarios and highlights the role of esophagectomy or surgical resection.","PeriodicalId":508891,"journal":{"name":"Foregut: The Journal of the American Foregut Society","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139380580","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}
Pub Date : 2023-12-30DOI: 10.1177/26345161231222199
Jarlath C. Bolger, Ralph Gilbert, Jonathan C. Yeung
Cervical esophageal cancers are rare and generally treated with definitive chemoradiation rather than trimodality therapy due to the need for pharyngolaryngectomy and esophagectomy. However, surgery remains indicated to salvage residual or recurrent disease. We review the management of cervical esophageal cancer and present a case series of complex surgical resection.
{"title":"Complex Resections: Management of Cervical Squamous Cell Carcinoma","authors":"Jarlath C. Bolger, Ralph Gilbert, Jonathan C. Yeung","doi":"10.1177/26345161231222199","DOIUrl":"https://doi.org/10.1177/26345161231222199","url":null,"abstract":"Cervical esophageal cancers are rare and generally treated with definitive chemoradiation rather than trimodality therapy due to the need for pharyngolaryngectomy and esophagectomy. However, surgery remains indicated to salvage residual or recurrent disease. We review the management of cervical esophageal cancer and present a case series of complex surgical resection.","PeriodicalId":508891,"journal":{"name":"Foregut: The Journal of the American Foregut Society","volume":" 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138361","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}
Pub Date : 2023-12-24DOI: 10.1177/26345161231218874
N. Zhou, W. Hofstetter
Previous clinical trials have concluded that trimodality and bimodality therapy are equivalent for treating locally advanced esophageal squamous cell carcinoma (ESCC). However, the use of chemoradiation alone achieves only a 45% to 50% complete response rate. Surgery remains crucial for locoregional control. In ESCC, salvage esophagectomy for locoregional recurrence has increased morbidity compared to planned esophagectomy. Retrospective data suggest that patients requiring cervical/upper chest anastomosis are more likely to undergo salvage esophagectomy rather than completing trimodality therapy. It’s unclear if selective surgery versus an operative approach on all patients after chemoradiation leads to differences in overall outcomes.
{"title":"Salvage Esophagectomy: Why it Makes Sense to Selectively Resect Squamous Cell Carcinoma","authors":"N. Zhou, W. Hofstetter","doi":"10.1177/26345161231218874","DOIUrl":"https://doi.org/10.1177/26345161231218874","url":null,"abstract":"Previous clinical trials have concluded that trimodality and bimodality therapy are equivalent for treating locally advanced esophageal squamous cell carcinoma (ESCC). However, the use of chemoradiation alone achieves only a 45% to 50% complete response rate. Surgery remains crucial for locoregional control. In ESCC, salvage esophagectomy for locoregional recurrence has increased morbidity compared to planned esophagectomy. Retrospective data suggest that patients requiring cervical/upper chest anastomosis are more likely to undergo salvage esophagectomy rather than completing trimodality therapy. It’s unclear if selective surgery versus an operative approach on all patients after chemoradiation leads to differences in overall outcomes.","PeriodicalId":508891,"journal":{"name":"Foregut: The Journal of the American Foregut Society","volume":"381 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139160919","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}
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