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find Author "韩泳涛" 10 results
  • 食管小细胞未分化癌24例报告

    我院1987~2000年13年间收治食管小细胞未分化癌24例,男21例,女3例,年龄36~72岁,平均56岁; 病程为20天至12个月,平均3个月。主要症状为吞咽困难23例,仅能进流汁或半流饮食; 呼吸困难1例。术前均行食管钡餐检查,诊断为食管癌22例,误诊为食管平滑肌肉瘤2例。术前行食管镜或胃镜检查并活检23例,均诊断为食管癌,其中小细胞未分化癌16例,低分化癌5例,另2例为恶性肿瘤细胞,可能来源于腺上皮。另1例因呼吸困难行纤维支气管镜检查,发现左右支气管受外压而变狭窄,未作活检。24例均采用以外科手术为主的综合治疗。肿瘤位于食管胸上段4例,胸中段15例,胸下段5例; 肿瘤长度为4~15 cm,平均8.7 cm; 相邻脏器受肿瘤浸润明显,局部淋巴结肿大。24例术后病理诊断均为食管小细胞未分化癌。病理类型有蕈伞型15例,髓质型6例和腔内型3例,其中16例嗜银染色,癌细胞浆内有大小不等、分布不均的棕黑色还原银颗粒; 8例免疫组化染色,癌细胞神经元特异性烯醇化酶呈强阳性,其中7例角蛋白散在阳性,1例阴性。淋巴结有癌细胞转移21例(87.5%)。临床TNM分期,Ⅲ期19例,Ⅲa期3例,Ⅲb期和Ⅳ期各1例。24例中行单纯根治性切除12例,平均生存期为9.4个月; 根治性切除+术后放疗6例,平均生存期为5.2个月; 姑息性切除+术前/术后放疗6例,平均生存期为4.1个月。

    Release date:2016-08-28 04:48 Export PDF Favorites Scan
  • Prophylactic Treatment Measures against Delayed Gastric Emptying after Ivor Lewis Esophagectomy

    目的:总结食管胸段癌Ivor Lewis食管切除术后胃延迟排空的防治对策。方法:回顾性分析我院3100例食管胸中下段癌行Ivor Lewis食管切除术后胃延迟排空的发生率。根据术中采取不同措施分为:A组(裂孔切开)和B组(不作裂孔切开),P组(幽门括约肌捏断)和N组(不作幽门处理),管胃组(管胃替代食管)和全胃组(全胃代食管),PM组(幽门括约肌捏断) 、PN组(不作幽门处理)和PP组(幽门成形)。比较不同处理方式前后胃延迟排空的发生率。结果:Ivor Lewis食管切除术后胃延迟排空的总的发生率为13.8%(427/3100)。术中裂孔扩大后胃延迟排空的发生率从32%(A组)降至21%(B组)(Plt;0.05);术中同时行幽门括约肌捏断后胃延迟排空的发生率从21%(N组)降至9%(P组)(Plt;0.05);采用管胃替代食管后胃延迟排空的发生率从19.5%(全胃组)降至8.3%(管胃组)(Plt;0.05);管胃组中PN组胃延迟排空的发生率为15%,PP组为8%,行幽门成形(PP组)后降至2% (Plt;0.05)。结论:胃延迟排空是Ivor Lewis食管切除术后主要的并发症,术中扩大食管裂孔、管胃替代食管和幽门成形可有效防治术后胃延迟排空的发生。

    Release date:2016-09-08 10:12 Export PDF Favorites Scan
  • Progress of clinical trials for immunotherapy drugs in advanced esophageal cancer

    Early and mid-stage esophageal cancer can achieve a particular effect through surgeries or comprehensive treatment based on surgery. Once the esophageal cancer progresses to the advanced stage, it is still lack of effective remedy for the disease, and the patient's prognosis is poor. Immunotherapy has developed rapidly in recent years, bringing dawn to patients with advanced esophageal cancer. On July 31, 2019, the US Food and Drug Administration (FDA) approved KEYTRUDA (Merck) for the treatment of esophageal squamous cell carcinoma, and it became the first milestone drug for esophageal squamous cell carcinoma. In the paper, we will review the progress of immunotherapy in the treatment of advanced esophageal cancer on the basis of current clinical researches, which might provide ideas for further studies in the immunotherapy for esophageal cancer.

    Release date:2020-07-30 02:16 Export PDF Favorites Scan
  • 第四届东亚食管癌多学科综合治疗学术会议亮点

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  • Comparative study of prognostic nutritional index and patient-generated subjective global assessment in perioperative nutritional prediction in patients with esophageal cancer

    ObjectiveTo investigate the prognostic value and consistency of prognostic nutritional index (PNI) and patient-generated subjective global assessment (PG-SGA) in perioperative nutritional status of patients with esophageal cancer.MethodsClinical data of 224 patients, including 186 males and 38 females with an average age of 63.08±8.42 years, who underwent esophageal cancer surgery in our hospital from November 2017 to August 2018 were retrospectively reviewed. The PNI was calculated according to the results of the first time blood and biochemical tests, and the PG-SGA assessment was also performed. According to the PNI value, the patients were divided into a good nutrition group (PNI≥45, 60 patients) and a malnutrition group (PNI<45, 164 patients). According to the PG-SGA score, the patients were divided into a good nutrition group (PG-SGA<4, 75 patients) and a malnutrition group (PG-SGA≥4, 149 patients). Nutrition-related haematological indexes and body mass index (BMI) were compared between the two groups, and the consistency of PNI and PG-SGA for nutritional assessment was analyzed.ResultsThe nutrition-related haematological indexes in different PNI groups were statistically different in the perioperative period (P<0.01). The longitudinal changes of prealbumin in patients of different PG-SGA groups were statistically different (P<0.05); the BMI of patients in different PG-SGA groups was statistically different in the perioperative period (P<0.01). The Kappa coefficient of the two indicators was 0.589 (P<0.001).ConclusionBoth PNI and PG-SGA can predict the nutritional risk of patients with esophageal cancer to some extent. PNI is an objective monitoring indicator, and PG-SGA is a subjective evaluation indicator, the combined use of which can more comprehensively reflect and predict the nutritional status of patients, and provide an important reference to the development of individualized nutrition support programs.

    Release date:2020-04-26 03:44 Export PDF Favorites Scan
  • 第 16 届国际食管疾病学会(ISDE)大会于维也纳顺利召开

    Release date:2018-11-27 04:47 Export PDF Favorites Scan
  • The symptoms and influencing factors of patients with esophageal cancer in postoperative rehabilitation

    ObjectiveTo analyze the symptom characteristics and influencing factors in order to provide reference for symptom management of patients with esophageal cancer after operation.MethodsA total of 216 esophageal cancer patients, including 180 males and 36 females with an average age of 63.7±8.3 years, who underwent surgical operation in our hospital from March to October 2018 were recruited and investigated with self-designed symptom questionnaire at 1 month after surgery.ResultsThe top five symptoms were acid reflux (48.6%), cough (42.6%), dysphagia (40.7%), hoarseness (12.0%), and diarrhea (11.6%). Women were more prone to acid reflux (OR=2.053), fatigue (OR=1.932), chest pain (OR=3.681), sleep disturbance (OR=2.419), abdominal pain (OR=3.882), nausea (OR=3.014) and vomiting (OR=2.505). Patients over 60 years were more prone to dysphagia (OR=2.274). Patients with lower thoracic esophageal cancer had a higher incidence of dysphagia compared with patients with carcinoma of esophagogastric junction (OR=0.326). Patients who had neoadjuvant chemotherapy were more likely to suffer acid reflux (OR=1.594). Open surgery (OR=3.681) and neoadjuvant radiotherapy (OR=2.495) were the risk factors of chest pain.ConclusionThere are many symptoms in patients with esophageal cancer after operation, and the occurrence of symptoms is closely related to gender, age, tumor location, surgical procedure and neoadjuvant chemoradiotherapy.

    Release date:2020-01-17 05:18 Export PDF Favorites Scan
  • COVID-19 infection after minimally invasive esophagectomy: Two cases report

    Two male patients (75 years and 51 years, respectively) suffered infection of novel coronavirus after minimally invasive surgery for esophageal squamous cell carcinoma in Sichuan Cancer Hospital since December 2022. Both patients developed severe hypoxemia after surgery, and were treated with advanced oxygen therapy, antiviral therapy, hormone shock therapy, antibiotic anti-infection and nutritional support. The two patients stayed in the intensive care unit for 6 days and 8 days respectively. They were transferred to the general ward for symptomatic treatment and were discharged successfully. Both patients required low-flow oxygen maintenance after discharge. On the 20th day of follow-up after discharge, patient 1 still needed low-flow oxygen, his oxygen saturation could be maintained above 97%, but intermittent deoxygenation could be performed for half an hour. Patient 2 was in good condition on 35 days after discharge.

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  • Long-term survival of surgical versus non-surgical treatment for esophageal squamous cell carcinoma in patients ≥70 years: A retrospective cohort study

    ObjectiveTo compare the long-term survival of elderly patients with esophageal squamous cell carcinoma (ESCC) treated with surgical versus non-surgical treatment. MethodsA retrospective analysis was conducted on the clinical data of elderly patients aged ≥70 years with ESCC who underwent esophagectomy or radiotherapy/chemotherapy at Sichuan Cancer Hospital from January 2009 to September 2017. Patients were divided into a surgical group (S group) and a non-surgical group (NS group) according to the treatment method. The propensity score matching method was used to match the two groups of patients at a ratio of 1:1, and the survival of the two groups before and after matching was analyzed. ResultsA total of 726 elderly patients with ESCC were included, including 552 males and 174 females, with 651 patients aged 70-79 years and 75 patients aged≥80 years. There were 515 patients in the S group and 211 patients in the NS group. The median follow-up time was 60.8 months, and the median overall survival of the S group was 41.9 months [95%CI (35.2, 48.5)], while that of the NS group was only 24.0 months [95%CI (19.8, 28.3)]. The 1-, 3-, and 5-year overall survival rates of the S group were 84%, 54%, and 40%, respectively, while those of the NS group were 72%, 40%, and 30%, respectively [HR=0.689, 95%CI (0.559, 0.849), P<0.001]. After matching, 138 patients were included in each group, and there was no statistical difference in the overall survival between the two groups [HR=0.871, 95%CI (0.649, 1.167), P=0.352]. ConclusionCompared with conservative treatment, there is no significant difference in the long-term survival of elderly patients aged≥70 years who undergo esophagectomy for ESCC. Neoadjuvant therapy combined with surgery is still an important choice to potentially improve the survival of elderly patients with ESCC.

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  • Chinese thoracic surgery experts consensus on postoperative follow-up plans for esophageal squamous cell carcinoma

    Resection is one of the most important treatments for esophageal squamous cell carcinoma, and routine postoperative follow-up is an effective method for early detection and treatment of recurrent metastases, which can improve patients' quality of life and prognosis. This consensus aims to provide a reference for colleagues responsible for postoperative follow-up of esophageal squamous cell carcinoma patients in China, and further improve the standardization of the diagnosis and treatment of esophageal squamous cell carcinoma.

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