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Objective: The aim of study was to compare overall 5-year survival of esophageal cancer patients undergoing transthoracic esophagectomy with either neck or intrathoracic anastomosis, that is, McKeown and Ivor-Lewis esophagectomy. Background: No national studies comparing long-term survival after McKeown and ivor-Lewis esophagectomies in the West exist. Methods: This population-based nationwide study included all curatively intended transthoracic esophagectomies for esophageal adenocarcinoma or squamous cell carcinoma in Finland in 1987 to 2016, with follow-up until December 31, 2019. Cox proportional hazard models provided hazard ratios (HR) with 95% confidence intervals (ci) of all-cause 5-year mortality. The results were adjusted for age, sex, year of the operation, comorbidities, histology, stage, and neoadjuvant treatment. Adjusted model 2 included also tumor location and lymph node yield. Results: A total of 990 patients underwent McKeown (n = 278) or Ivor-Lewis (n = 712) esophagectomy The observed overall 5-year survival was 43.1% after McKeown, and 45.9% after Ivor-Lewis esophagectomy. McKeown esophagectomy was not associated with the overall 5-year mortality (adjusted HR 1.11, 95% CI: 0.89-1.38), compared to Ivor-Lewis esophagectomy. Additional adjustment for tumor location and lymphadenectomy further attenuated the point estimate (HR 1.06, 95% CI: 0.85–1.33). Surgical approach was not associated with 90-day mortality rate (adjusted HR 1.15, 95% CI: 0.67–1.97). Conclusions: This population-based nationwide study suggests that overall 5-year survival or 90-day survival with McKeown and Ivor-Lewis esopha-gectomy for esophageal cancer are comparable. [ABSTRACT FROM AUTHOR]

Background and aims:The incidence of gallstones and gallbladder sludge is higher in patients after total gastrectomy than in general population. Formation of gallstones after gastrectomy is multifactorial. Here, we investigate the changes in gallbladder and biliary tract functions by cholescintygraphy and monitored changes in cholecystokinin (CCK) release in long-term survivors after total gastrectomy for gastric carcinoma. Material and methods:Patients had undergone total gastrectomy for gastric carcinoma at least five years ago. The final study population consisted of 25 patients. Results:Eight patients had undergone cholecystectomy before or at the time of gastrectomy. Gallstone formation was observed in seven of the remaining 17 patients during follow-up (41%). Maximum uptake of radioactivity and gallbladder maximum uptake was significantly delayed in the gastrectomy group than in the control group. There was no significant difference in CCK levels after the overnight fasting and at 60 minutes after stimulation among patients with or without stonesin situcompared with healthy volunteers, but 30 minutes after the energy-rich drink patients had higher CCK levels than the control group. Conclusions:In gastrectomy patients, technetium isotope visualisation of the gallbladder and time for maximum activity was significantly delayed. This may indicate impaired gallbladder function. On the contrary, CCK release was not impaired. [ABSTRACT FROM PUBLISHER]

Background: No national studies comparing long-term survival after total or partial gastrectomy with splenectomy due to injury or due to oncological reasons or spleen preservation exist. The aim of the study was to examine the overall 5-year survival of gastric adenocarcinoma patients undergoing total or partial gastrectomy with splenectomy due to injury or oncological reasons or spleen preservation in a population-based nationwide setting., Methods: This study included all patients undergoing total or partial gastrectomy with splenectomy or spleen preservation for gastric adenocarcinoma in Finland in 2005-2016, with follow-up until December 31, 2019. A total of 2,196 patients with gastric cancer diagnosis and total or partial gastrectomy were identified in the registries. Of these, 2,118 patients were applicable for this study. Cox proportional hazard models provided hazard ratios (HR) with 95% confidence intervals (CI) of overall 5-year survival. Results were adjusted for age, sex, year of operation, comorbidities, tumor location, pathological stage, and neoadjuvant therapy., Results: The observed overall 5-year survival was 38.7% in patients with no or minor spleen injury, 39.7% in patients with splenectomy due to injury and 30.8% in patients with splenectomy due to oncological reasons (p=0.032). R0 gastrectomy with splenectomy due to oncological reasons was associated with higher 5-year mortality (the adjusted model HR 1.26, 95% CI 1.01-1.56) compared to patients with spleen preservation., Conclusion: The overall survival is worst in gastrectomy patients with splenectomy due to oncological reasons highlighting the poor prognosis in patients with advanced gastric cancer. Splenectomy due to injury does not compromise prognosis., Competing Interests: Declarations of interest None Declared., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)