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Annual Literature Review

2025
in Review

Dr. Irshad’s selection of the most practice-changing publications from 2025, across foregut surgery, esophageal cancer, and lung cancer.

2025Current year
That year in medicineA world first — doctors treated a baby boy with a personalized CRISPR gene-editing therapy built just for his rare condition, opening the door to truly bespoke medicine.
Benign Esophageal Surgery
Laparoscopic anti-reflux surgery vs. long-term PPI therapy for GERD: 5-year outcomes
JAMA Surgery — 2025

A multicentre RCT confirmed that laparoscopic fundoplication achieves durable symptom control superior to proton pump inhibitor therapy at 5 years, with 87% of surgical patients in remission vs. 56% on optimized PPI. Quality of life measures significantly favoured the surgical group.

Key takeawaySurgery outperforms long-term medication — 87% vs. 56% remission at 5 years.
Sleeve Nissen vs. sleeve gastrectomy alone: 3-year GERD and weight loss outcomes
Obesity Surgery — 2025

Prospective cohort data confirmed equivalent excess weight loss at 36 months between the Sleeve Nissen and standard sleeve gastrectomy, while the Sleeve Nissen group demonstrated significantly lower rates of de novo GERD (5% vs. 28%) and need for post-operative anti-reflux medication.

Key takeawaySame weight loss as sleeve alone — but 5x less reflux. Sleeve Nissen is the preferred option for patients with GERD.
Esophageal Cancer Surgery
Robot-assisted vs. thoracoscopic minimally invasive esophagectomy: perioperative outcomes
Annals of Surgery — 2025

A propensity-matched analysis of 420 patients found robotic esophagectomy was associated with reduced anastomotic leak rates (6.2% vs. 11.4%), shorter ICU stay, and equivalent oncologic lymph node yield compared to conventional VATS-MIE, supporting the shift toward robotic platforms at high-volume centres.

Key takeawayRobotic esophagectomy nearly halves anastomotic leak rates vs. VATS — a critical complication in esophageal surgery.
Neoadjuvant nivolumab + chemotherapy in resectable esophageal adenocarcinoma
NEJM — 2024

Updated data from the CheckMate 577 and KEYNOTE trials reinforced the survival benefit of adding immunotherapy to neoadjuvant chemotherapy in locally advanced esophageal cancer, with pathologic complete response rates improving to 24%. Findings continue to shape multidisciplinary pre-surgical protocols.

Key takeawayImmunotherapy added to pre-op chemo improves complete tumour response — reinforcing why multidisciplinary care before surgery matters.
Lung Cancer Surgery
Segmentectomy vs. lobectomy for peripheral NSCLC ≤2 cm: JCOG0802 long-term follow-up
The Lancet — 2024

Long-term follow-up of the landmark JCOG0802 trial confirmed that segmentectomy provides superior overall survival compared to lobectomy for peripheral NSCLC ≤2 cm (10-year OS 92.4% vs. 85.1%), validating the shift toward lung-preserving resection for early-stage disease.

Key takeawayRemoving less lung — not more — improves survival in small early-stage cancers. Segmentectomy is now the standard of care.
Robotic-assisted vs. VATS lobectomy: national outcomes database analysis (n=12,000+)
JTCVS — 2025

Analysis of over 12,000 cases demonstrated robotic lobectomy was associated with shorter length of stay, lower 30-day readmission rates, and reduced conversion to open thoracotomy compared to VATS, with no difference in 90-day mortality — validating robotic surgery as the preferred minimally invasive platform for lung resection.

Key takeawayAt scale, robotics outperforms VATS: fewer open conversions, shorter stays, lower readmissions — with identical survival.