ObjectiveTo study the gastric function of vagus-preserved patients after esophagectomy, and to evaluate the significance of keeping vagus and the value of gastric tube with vagal-sparing esophagectomy. MethodsWe retrospectively analyzed clinical data of 15 patients in West China Hospital between June 2012 and January 2014. They were divided into two groups. There were 8 patients with 6 males and 2 females with average age of 57 years ranging from 44 to 77 years, in a gastric pull-up group with vagal-sparing esophagectomy. There were 7 patients with 6 males and 1 female at average age of 60 years ranging from 50 to 70 years in a gastric tube group with vagal-sparing esophagectomy. We chose 8 patients with 7 males and 1 female at average age of 62 years ranging from 47 to 69 years as a control group with a classical esophagectomy and a gastric pull-up. Then we evaluated the function of the vagal nerves and gastric reservoir after vagal-sparing esophagectomy. ResultsAll 23 surgeries were successfully performed. In subjective symptom, diarrhea was rare in the vagal-sparing esophagectomy patients and statistically more common in patients with a standard esophagectomy. Dumping and early satisfaction situation were similar among 3 groups. The 60 minutes gastric emptying rate was much better in the vagal-sparing group than that in the control group. And the esophageal manometry of the vagal-sparing group was statistically hihger than that in the control group. The gastroscope showed that the incidence of reflux esophagitis in the vagal-sparing group was statistically lower than that of the control group. There was no statistic difference in weight in the vagus-preserved group before and after the surgery while the weight decreased statistically in the control group. ConclusionsFor both esophageal replacement and gastric tube, preserving the vagus can reduce the functional dyspepsia after esophagectomy.
Abstract： Surgery is an effective therapy for non-small cell lung cancer (NSCLC). The standard operation includes lobectomy and systematic dissection of lymph nodes. However, postoperative tumor recurrence is common even among incipient patients due to incomplete dissection of lymph nodes and micrometastasis of lymph nodes. Injecting a carbon nanoparticles suspension is a new technique aimed at preventing this recurrence. The carbon nanoparticles carry lymph node tracers that help surgeons locate lymph nodes in order to clean them thoroughly. The tracers also target the lymph nodes for chemotherapy, thus killing residual tumor cells intraoperatively to avoid postoperative cancer recurrence. Carbon nanoparticles suspension injection is already widely and successfully used in surgery for gastrointestinal and mammary gland tumors, and is being tested for effectiveness in NSCLC patients. Some studies have indicated that carbon nanoparticles suspension injection is effective in NSCLC patients and improves their prognoses. We reviewed the features, application methods, and clinical applications of studies of carbon nanoparticles suspension injection for NSCLC.
ObjectiveTo discuss the causes of esophageal benign diseases and how to prevent, diagnose and treat such diseases. MethodsWe reviewed and analyzed the clinical data of 162 patients with esophageal benign diseases treated in our hospital from March 1994 to July 2011. Causes, diagnosis, treatment and prognosis of this kind of diseases were analyzed and summarized. ResultsEighty-five patients had definite inducements. All patients were diagnosed through barium swallow radiography, CT, and gastroscopic inspection and underwent operation. A total of 155 patients were cured by positive treatment, but 7 patients died because of severe infection. ConclusionMost patients suffering from esophageal benign diseases have definite inducements. Therefore, many such diseases can be prevented. Once being confirmed, active surgery is the main treatment. Most patients can be cured if treatment is performed in time.
ObjectiveTo explore the effect of body mass index (BMI) on therapeutic effect and surgical risk of esophagectomy. MethodsWe retrospectively collected the data of 494 patients who underwent esophagectomy in West China hospital of Sichuan University between March 2014 and March 2015. According to BMI, all patients were allocated to three groups: an obesity group (BMI≥25 kg/m2) of 74 patients, a normal weight group (18.5 kg/m2≤BMI < 25 kg/m2) of 345 patients, and a low weight group (BMI < 18.5 kg/m2) of 75 patients. ResultsThere were no statistical differences in the intraoperative blood loss (213.33±55.10 ml vs. 218.90±60.76 ml vs. 217.30±61.10 ml), operation time (197.07±52.47 min vs. 208.35±96.84 min vs. 182.84±63.06 min), incidence of postoperative complication (38.7% (29/75) vs. 43.2% (149/345) vs. 39.2% (29/74), the number of resected lymphnodes (l16.18±6.64 vs. 16.68 ±8.48 vs. 8.48±8.26), and the number of the metastatic lymphnodes (1.42±2.53 vs. 1.32±2.51 vs. 2.45±4.08) among the low weight group, the normal weight group, and the obesity group. ConclusionObesity and low weight do not increase the surgical risk and influence the surgical outcome. Therefore, obesity and low weight should not interfere with the operative choice of patients with esophageal cancer.