Back to Evidence
Annual Literature Review

2023
in Review

Dr. Irshad’s selection of the most practice-changing publications from 2023, across foregut surgery, esophageal cancer, and lung cancer.

Annual reviews2025202420232022← Back to Evidence
2023
That year in medicineThe first CRISPR gene-editing therapy was approved — a one-time treatment that can free people with sickle-cell disease from a lifetime of pain crises.
Benign Esophageal Surgery
Laparoscopic Heller myotomy vs. peroral endoscopic myotomy (POEM) for achalasia: 5-year RCT follow-up
Annals of Surgery — 2023

Five-year follow-up of a multicentre RCT comparing laparoscopic Heller myotomy with Dor fundoplication versus POEM found equivalent symptom remission rates (85% vs. 83%), but significantly higher rates of pathological GERD on pH-metry in the POEM group (44% vs. 21%). Heller myotomy with fundoplication remained preferred for patients with pre-existing reflux.

Key takeawayBoth procedures work equally well for swallowing — but surgical myotomy with wrap is better for patients who also have reflux.
Magnetic sphincter augmentation vs. fundoplication for GERD: long-term quality of life outcomes
JAMA Surgery — 2023

A prospective comparative study of 380 patients found magnetic sphincter augmentation (LINX) and laparoscopic Nissen fundoplication achieved equivalent symptom control at 3 years. Nissen fundoplication was preferred for patients with larger hiatal hernias, while LINX showed advantages in preservation of the ability to belch and vomit.

Key takeawayFor GERD without a large hernia, both operations work well — patient preference and anatomy guide the choice.
Esophageal Cancer Surgery
CROSS trial: 10-year overall survival after neoadjuvant chemoradiotherapy and surgery for esophageal cancer
Journal of Clinical Oncology — 2023

Ten-year follow-up of the landmark CROSS trial confirmed durable survival benefit of neoadjuvant chemoradiation (carboplatin/paclitaxel + 41.4 Gy) prior to esophagectomy. Overall survival at 10 years was 38% in the combined modality arm vs. 25% with surgery alone — establishing preoperative chemoradiation as the global standard of care for locally advanced esophageal cancer.

Key takeawayPre-op chemoradiation improves 10-year survival by 13 percentage points — cementing its role before surgery in locally advanced disease.
Robotic-assisted minimally invasive esophagectomy: learning curve and outcomes at a high-volume centre
Diseases of the Esophagus — 2023

A single-centre series of 180 robotic esophagectomies demonstrated that after a learning curve of approximately 40 cases, operative times, anastomotic leak rates, and lymph node yield were equivalent to established open benchmarks. Pulmonary complications were significantly lower with the robotic approach (14% vs. 28% open historical controls).

Key takeawayRobotic esophagectomy cuts lung complications in half once the learning curve is overcome — volume and experience are critical.
Lung Cancer Surgery
JCOG0802: segmentectomy vs. lobectomy for peripheral NSCLC ≤2 cm — primary results
The Lancet — 2023

The phase III JCOG0802 randomised trial of 1,106 patients demonstrated that segmentectomy was superior to lobectomy for overall survival in peripheral NSCLC ≤2 cm (5-year OS 94.3% vs. 91.1%, HR 0.663), while preserving significantly more lung function. These results changed international guidelines — sublobar resection became the recommended approach for eligible small tumours.

Key takeawayA practice-changing trial: for small lung cancers, segmentectomy is now superior to lobectomy — better survival and better lung function.
CheckMate 816: neoadjuvant nivolumab + chemotherapy in resectable NSCLC — 3-year follow-up
New England Journal of Medicine — 2023

Three-year follow-up of the CheckMate 816 trial confirmed event-free survival benefit of adding nivolumab to neoadjuvant chemotherapy before resection of stage IB–IIIA NSCLC (EFS 31.6 vs. 20.8 months). Pathological complete response rate was 24% vs. 2.2% — a result that has transformed pre-operative protocols for resectable lung cancer.

Key takeawayAdding immunotherapy before lung cancer surgery dramatically increases the chance of no residual cancer at the time of resection.