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Kaplan M, Tanoglu A, Sakin YS, Akyol T, Oncu K, Kara M, Yazgan Y. Landmark reading alterations in patients with gastro-oesophageal reflux symptoms undergoing diagnostic gastroscopy. Arab J Gastroenterol 2016; 17:176-180. [PMID: 27889322 DOI: 10.1016/j.ajg.2016.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 08/21/2016] [Accepted: 08/28/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND STUDY AIMS There is still a debate about the exact measurement of the oesophagogastric junction and the diaphragmatic hiatus among clinicians. The aim of this study was to investigate the differences between landmark readings of gastroscopy on intubation and extubation, and to correlate these readings with a gastro-oesophageal reflux questionnaire. PATIENTS AND METHODS 116 cases who underwent diagnostic gastroscopy between January 2013 and June 2013 were included in this study. Landmark measurements were noted while withdrawing the endoscope and were also evaluated after the gastric air was fully emptied. We first used a frequency scale for the gastro-oesophageal reflux disease symptoms (FSSG) questionnaire in order to investigate dysmotility and acid reflux symptoms in the study population and correlated the FSSG questionnaire with intubation and extubation measurements at endoscopic examination. RESULTS Mean age of included subjects was 49.41±17.7 (19-82) years. Males and females were equally represented. On FSSG scores, the total dysmotility score was 7.99±5.06 and the total score was 15.18±10.11. The difference between intubation and extubation measurements ranged from -3cm to +2cm (mean: -0.4). When an FSSG score of 30 was accepted as a cut-off value, we detected a significant difference between the measurements (p<0.05; t: 0.048). CONCLUSION Accuracy of landmark measurements during gastroscopy is clearly affected from insertion or withdrawal of the endoscope. When differences in measurements between insertion and withdrawal were evident, comparable with the FSSG scores, the results became significantly different. In conclusion, according to FSSG scores, these measurements should be performed at the end of the endoscopy.
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Affiliation(s)
- Mustafa Kaplan
- GATA Haydarpasa Training Hospital, Internal Medicine Department, 34668 Uskudar, Istanbul, Turkey.
| | - Alpaslan Tanoglu
- GATA Haydarpasa Training Hospital, Gastroenterology Department, 34668 Uskudar, Istanbul, Turkey.
| | - Yusuf Serdar Sakin
- GATA Ankara Training Hospital, Gastroenterology Department, 06034 Ankara, Turkey.
| | - Taner Akyol
- GATA Haydarpasa Training Hospital, Gastroenterology Department, 34668 Uskudar, Istanbul, Turkey.
| | - Kemal Oncu
- GATA Haydarpasa Training Hospital, Gastroenterology Department, 34668 Uskudar, Istanbul, Turkey.
| | - Muammer Kara
- GATA Haydarpasa Training Hospital, Gastroenterology Department, 34668 Uskudar, Istanbul, Turkey.
| | - Yusuf Yazgan
- GATA Haydarpasa Training Hospital, Gastroenterology Department, 34668 Uskudar, Istanbul, Turkey.
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Miccio JA, Oladeru OT, Yang J, Xue Y, Choi M, Zhang Y, Yoon H, Ryu S, Stessin AM. Neoadjuvant vs. adjuvant treatment of Siewert type II gastroesophageal junction cancer: an analysis of data from the surveillance, epidemiology, and end results (SEER) registry. J Gastrointest Oncol 2016; 7:403-10. [PMID: 27284473 DOI: 10.21037/jgo.2015.10.06] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Cancer of the gastroesophageal junction (GEJ) has been rising in incidence in recent years. The role of radiation therapy (RT) in the treatment of GEJ cancer remains unclear, as the largest prospective trials advocating for either adjuvant or neoadjuvant chemoradiotherapy (CRT) combine GEJ cancer with either gastric or esophageal cancer. The aim of the present study is to examine the association of neoadjuvant versus adjuvant treatment with overall and disease-specific survival (DSS) for patients with surgically resected cancer of the true GEJ (Siewert type II). METHODS The surveillance, epidemiology, and end results (SEER) registry database (2001-2011) was queried for cases of surgically resected Siewert type II GEJ cancer. A total of 1,497 patients with resectable GEJ cancer were identified, with 746 receiving adjuvant RT and 751 receiving neoadjuvant RT. Retrospective analysis was performed with the endpoints of overall and DSS. RESULTS Using cox regression and controlling for independent covariates (age, sex, race, stage, grade, histology, and year of diagnosis), we showed that adjuvant RT was associated with a significantly lower death risk [hazard ratio (HR), 0.84; 95% confidence interval 0.73-0.97; P value=0.0168] and significantly lower disease-specific death risk (HR, 0.84; 95% confidence interval, 0.72-0.97; P value=0.0211) as compared to neoadjuvant RT. CONCLUSIONS This analysis of SEER data showed that adjuvant RT was associated with a survival benefit as compared to neoadjuvant RT for the treatment of Siewert type II GEJ cancer. We suggest future prospective studies to compare outcomes of adjuvant versus neoadjuvant treatment for true GEJ cancer.
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Affiliation(s)
- Joseph A Miccio
- 1 Department of Radiation Oncology, 2 Department of Preventive Medicine, 3 Department of Applied Mathematics and Statistics, 4 Department of Gastrointestinal Medical Oncology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Oluwadamilola T Oladeru
- 1 Department of Radiation Oncology, 2 Department of Preventive Medicine, 3 Department of Applied Mathematics and Statistics, 4 Department of Gastrointestinal Medical Oncology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Jie Yang
- 1 Department of Radiation Oncology, 2 Department of Preventive Medicine, 3 Department of Applied Mathematics and Statistics, 4 Department of Gastrointestinal Medical Oncology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Yaqi Xue
- 1 Department of Radiation Oncology, 2 Department of Preventive Medicine, 3 Department of Applied Mathematics and Statistics, 4 Department of Gastrointestinal Medical Oncology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Minsig Choi
- 1 Department of Radiation Oncology, 2 Department of Preventive Medicine, 3 Department of Applied Mathematics and Statistics, 4 Department of Gastrointestinal Medical Oncology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Yue Zhang
- 1 Department of Radiation Oncology, 2 Department of Preventive Medicine, 3 Department of Applied Mathematics and Statistics, 4 Department of Gastrointestinal Medical Oncology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Hannah Yoon
- 1 Department of Radiation Oncology, 2 Department of Preventive Medicine, 3 Department of Applied Mathematics and Statistics, 4 Department of Gastrointestinal Medical Oncology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Samuel Ryu
- 1 Department of Radiation Oncology, 2 Department of Preventive Medicine, 3 Department of Applied Mathematics and Statistics, 4 Department of Gastrointestinal Medical Oncology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Alexander M Stessin
- 1 Department of Radiation Oncology, 2 Department of Preventive Medicine, 3 Department of Applied Mathematics and Statistics, 4 Department of Gastrointestinal Medical Oncology, Stony Brook University, Stony Brook, NY 11794, USA
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