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Annual Literature Review

2024
in Review

Dr. Irshad’s selection of the most practice-changing publications from 2024, across foregut surgery, esophageal cancer, and lung cancer.

2024
That year in medicineA twice-a-year injection, lenacapavir, was shown to prevent almost all new HIV infections in trials — hailed as the science breakthrough of the year.
Benign Esophageal Surgery
Robotic vs. laparoscopic fundoplication for GERD: a multicentre comparative study
Surgical Endoscopy — 2024

A prospective multicentre analysis comparing robotic and laparoscopic Nissen fundoplication found equivalent symptom control and wrap durability at 2 years, with robotic surgery associated with lower intraoperative complication rates and reduced conversion to open surgery in revisional cases.

Key takeawayRobotic fundoplication offers a safer option for complex or revisional anti-reflux surgery — same outcomes, fewer complications.
Long-term outcomes of laparoscopic repair for giant paraesophageal hernia: 10-year series
Annals of Surgery — 2024

A 10-year single-centre series of over 300 laparoscopic giant paraesophageal hernia repairs reported a recurrence rate of 8.4% at 10 years with mesh reinforcement, and a symptom resolution rate exceeding 90%. Emergency presentations and open conversions were rare in experienced hands.

Key takeawayLaparoscopic repair of giant hernias is durable and safe long-term — recurrence is low when performed at high-volume centres.
Esophageal Cancer Surgery
CheckMate 577: extended follow-up of adjuvant nivolumab after neoadjuvant chemoradiation and resection
Journal of Clinical Oncology — 2024

Extended follow-up from the CheckMate 577 trial confirmed sustained disease-free survival benefit of adjuvant nivolumab in patients with resected esophageal or gastroesophageal junction cancer who did not achieve pathological complete response after neoadjuvant chemoradiation (median DFS 22.4 vs. 11.0 months, HR 0.67).

Key takeawayPost-surgical immunotherapy nearly doubles disease-free survival for patients who still had residual cancer after pre-op treatment.
Minimally invasive vs. open esophagectomy: updated meta-analysis of randomised and propensity-matched data
Lancet Oncology — 2024

A comprehensive meta-analysis of 18 studies confirmed MIE is associated with significantly lower pulmonary complication rates (OR 0.48), shorter hospital stay, and equivalent 5-year overall survival compared to open esophagectomy — cementing minimally invasive surgery as the standard of care at experienced centres.

Key takeawayMIE cuts lung complications in half vs. open surgery — same cancer control, dramatically less post-op morbidity.
Lung Cancer Surgery
ADAURA trial: 5-year overall survival with adjuvant osimertinib in EGFR-mutated NSCLC
New England Journal of Medicine — 2024

Five-year follow-up of the ADAURA trial established that adjuvant osimertinib (targeted EGFR therapy) after complete resection of stage IB–IIIA EGFR-mutated NSCLC improved overall survival to 88% vs. 78% with placebo — the first adjuvant targeted therapy to demonstrate an OS benefit in resected lung cancer.

Key takeawayGenetic testing after lung cancer surgery now directly changes treatment — EGFR-positive patients benefit significantly from post-op targeted therapy.
CALGB 140503: segmentectomy vs. lobectomy for stage IA NSCLC — 5-year results
NEJM — 2023/2024

The CALGB 140503 randomised trial demonstrated non-inferior disease-free survival for segmentectomy compared to lobectomy in clinical stage IA NSCLC ≤2 cm. Together with JCOG0802, these results have fundamentally changed guidelines — sublobar resection is now the preferred operation for appropriate small peripheral tumours.

Key takeawayTwo landmark RCTs now agree: for small lung cancers, less is more. Segmentectomy preserves lung function without sacrificing survival.