All groups were compared in terms of Pt[O.sup.2] levels before, right after, and 30 days after gastrectomy; burst pressure of the gastrectomy line; and hydroxyproline level at the EGJ. Comparisons of Pt[O.sup.2] measurements, gastrectomy line burst pressures, EGJ tissue hydroxyproline levels, and change ratios of Pt[O.sup.2] levels among the four study groups were analyzed with Kruskal-Wallis test.
Tissue partial oxygen pressure at the EGJ was measured before gastrectomy (Pt[O.sup.2]-0), right after gatrectomy (Pt[O.sup.2]-1), and on the 30th day following the laparotomy (Pt[O.sup.2]-30).
There was no significant change after ESD in CFV and DL (which evaluate contraction wave pattern), IBP and IRP (which evaluate EGJ
relaxation), or PB (which indicates peristalsis deficit length; Table 3).
Studies were included if they met the following criteria: (1) the diagnoses of esophageal and EGJ carcinoma and PNI were based on pathological examination; (2) the studies reported the outcome of OS or disease-free survival (DFS); (3) they provided hazard ratio (HR) with confidence interval (CI) or original data sufficient for calculating them.
A pooled analysis of 13 cohorts including 16 HRs demonstrated that PNI was associated with poor OS in esophageal and EGJ carcinoma (HR = 1.76, 95% CI: 1.54-2.20, and P < 0.00001; Figure 2).
For cancers of the EGJ
, this regimen is also employed, but in a neoadjuvant role.
Because this impacts the esophagus primarily, this manuscript will use UICC terminology for lung, mesothelioma, and thymic staging, and AJCC terminology for esophagus and EGJ
Three (5.2%) patients had EGJ
outflow obstruction, 3 (5.2%) patients had distal esophageal spasm, 2 (3.4%) patients had hypercontractile esophagus, 3 (5.2%) patients had fragmented peristalsis, and 12 (17.2%) had ineffective esophageal motility (IEM), which are defined as [greater than or equal to]50% infective swallows and DCI < 450 mmHg-s-cm .
In this method, only circular muscle layer was cut from approximately 8 cm to 2 cm above the EGJ
. Then both inner circular muscular layer and outer longitudinal muscular layer were cut from 2 cm above the EGJ
to the fundus of the stomach (Figures 1(e) and 2(a-1)).
(3) For designation of the EGJ
, it is only clinically usable when the disease damage in the EGJ
region is minimal (4) and the patient does not have a hiatal hernia.
The integrated relaxation pressure (IRP) is the mean EGJ
pressure measured using the electronic equivalent of a sleeve sensor for four continuous or noncontinuous seconds of relaxation in the 10-second window following deglutitive upper esophageal sphincter relaxation.
Recently, there has been a large interest in modified versions of this technique that are based on the creation of an esophageal submucosal tunnel approximately 13 cm proximal to the EGJ
to further create a myotomy of the inner circular esophageal muscle fibers .