A comprehensive meta-analysis of 28 studies and over 4,000 patients confirmed that laparoscopic fundoplication achieves durable symptom control in 80–90% of patients at 10 years, with 60–70% remaining off PPIs at long-term follow-up. Reoperation rates were low (5–8%) and quality of life scores significantly exceeded those of patients on continuous medical therapy.
A national database analysis demonstrated a strong inverse relationship between surgeon volume and morbidity in giant paraesophageal hernia repair — high-volume surgeons (>20 cases/year) had significantly lower conversion rates (4% vs. 14%), shorter hospital stays, and fewer major complications. The findings reinforced the importance of referral to experienced centres for complex hernia repair.
Updated analysis of the KEYNOTE-590 trial confirmed that adding pembrolizumab (immunotherapy) to platinum-based chemotherapy significantly improved overall survival in advanced esophageal cancer (median OS 12.4 vs. 9.8 months; HR 0.73). The benefit was most pronounced in PD-L1 CPS ≥10 tumours, shaping the standard of care for patients presenting with unresectable or metastatic disease.
Five-year follow-up of the FLOT4 trial confirmed the survival advantage of perioperative FLOT chemotherapy (fluorouracil, leucovorin, oxaliplatin, docetaxel) over ECF/ECX for resectable gastroesophageal junction and gastric adenocarcinoma (5-year OS 45% vs. 36%). FLOT is now the standard perioperative regimen at most high-volume centres.
The landmark CheckMate 816 phase III trial demonstrated that adding nivolumab to neoadjuvant chemotherapy before surgery for stage IB–IIIA NSCLC significantly improved pathological complete response (24% vs. 2.2%) and event-free survival (31.6 vs. 20.8 months). The trial established immunotherapy + chemotherapy as the new standard pre-operative regimen for resectable lung cancer.
A propensity-matched analysis of 8,400 patients from a national thoracic surgery database found robotic lobectomy was associated with lower conversion rates to open thoracotomy (2.3% vs. 5.1%), reduced blood transfusion requirements, and shorter length of stay compared to VATS, with equivalent 30-day mortality and oncologic lymph node yield.