scholarly journals Surgeon at Work: Hand-Assisted Laparoscopic Construction of Gastric Conduit for Thoracic Esophageal Cancer

2001 ◽  
Vol 7 (2) ◽  
pp. 75-81 ◽  
Author(s):  
Tatsuya Aoki ◽  
Akihiko Tsuchida ◽  
Yoshiaki Osaka ◽  
Yu Takagi ◽  
Motoo Shinohara ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Surgical Procedure ◽  
Operating Time ◽  
Gastric Conduit ◽  
The Body ◽  
Greater Omentum ◽  
Esophageal Hiatus ◽  
Endoscopic Surgical Procedure ◽  
Thoracic Esophageal Cancer ◽  
Time Required

A method for hand-assisted laparoscopic construction of gastric conduit for thoracic esophageal cancer was developed. Since this endoscopic surgical procedure is less invasive than open surgery, it contributes to improvement of post-operative respiratory functions and reduces respiratory complications. What distinguishes our surgical procedure is that unlike methods described in previous reports, it begins with treatment of the left gastroepiploic vessels at the height of the inferior edge of the spleen, followed by dissection from the esophageal hiatus to the lesser curvature and then dissection and excision of left gastric arteries and veins. Finally, the exposed esophagus and stomach are drawn outside the body and the right gastroepiploic blood vessels are preserved, followed by dissection of the greater omentum. This approach to gastric conduit construction was undertaken in 6 patients and the mean operating time was 123 minutes. Although in the first 3 of these patients the operating time was 150 minutes or more, the time required shortened to around 90 minutes for each of the last 3 cases, as the procedure was mastered. In each case, the volume of intraoperative hemorrhage did not exceed 50 ml.

scholarly journals A safe and simple technique for nasogastric tube insertion in patients with thoracic esophageal cancer surgery

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Noriyuki Hirahara ◽  
Takeshi Matsubara ◽  
Shunsuke Kaji ◽  
Yuki Uchida ◽  
Tetsu Yamamoto ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Anastomotic Leakage ◽  
Nasogastric Tube ◽  
Simple Technique ◽  
Gastric Conduit ◽  
Intraluminal Pressure ◽  
Linear Stapler ◽  
Thoracic Esophageal Cancer ◽  
Nylon Thread ◽  
Lesser Curvature

Abstract Background Risk factors for anastomotic leakage include local factors such as excessive tension across anastomosis and increased intraluminal pressure on the gastric conduit; therefore, we consider the placement of a nasogastric tube to be essential in reducing anastomotic leakage. In this study, we devised a safe and simple technique to place an NGT during an end-to-side, automatic circular-stapled esophagogastrostomy. Methods First, a 4-0 nylon thread is fixed in the narrow groove between the plastic and metal parts of the tip of the anvil head. After dissecting the esophagus, the tip of the NGT is guided out of the lumen of the cervical esophageal stump. The connecting nylon thread is applied to the anvil head with the tip of the NGT. The anvil head is inserted into the cervical esophageal stump, and a purse-string suture is performed on the esophageal stump to complete the anvil head placement. The main unit of the automated stapler is inserted through the tip of a reconstructed gastric conduit, and the stapler is subsequently fired and an end-to-side esophagogastrostomy is achieved. The main unit of the automated stapler is then pulled out from the gastric conduit, and the NGT comes out with the anvil head from the tip of the reconstructed gastric conduit. Subsequently, the nylon thread is cut. After creating an α-loop with the NGT outside of the lumen, the tip of the NGT is inserted into the gastric conduit along the lesser curvature toward the caudal side. Finally, the inlet of the automated stapler on the tip of the gastric conduit is closed with an automated linear stapler, and the esophagogastrostomy is completed. Results We utilized this technique in seven patients who underwent esophagectomy for esophageal cancer; smooth and safe placement of the NGT was accomplished in all cases. Conclusion Our technique of NGT placement is simple, safe, and feasible.

RA02.01: COMPARISON OF THREE-FIELD VERSUS TWO-FIELD LYMPHADENECTOMY FOR THORACIC MIDDLE AND LOWER ESOPHAGEAL CANCER: POST-OPERATIVE RESULTS OF A RANDOMIZED CONTROLLED TRIAL

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 19-20
Author(s):  
Bin Li ◽  
Jiaqing Xiang ◽  
Yawei Zhang ◽  
Jie Zhang ◽  
Yihua Sun ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Postoperative Complications ◽  
Lymph Nodes ◽  
Conflicts Of Interest ◽  
Tumor Staging ◽  
Operating Time ◽  
Thoracic Esophageal Cancer ◽  
Term Survival

Abstract Background Patients with esophageal cancer can benefit from extended lymphadenectomy. However, the role of 3-field lymphadenectomy is unclear, and the extent of lymphadenectomy for thoracic esophageal cancer is still under discussion. Methods From June 2013 to November 2016, 400 patients with middle and lower thoracic esophageal cancer were randomly assigned to receive 3-field (3FL, n = 200) or the 2-field (2FL, n = 200) lymphadenectomy. The postoperative complications, according to the Clavien-Dindo classification, and lymph node metastasis were compared on the basis of intention-to-treat principle. Results Baseline characteristics were balanced between the 2 arms. There were 187 patients (93.5%) had squamous cell carcinoma in 3FL arm, and 192 (96.0%) in the 2FL arm, P = 0262. According to the pathological reports, T staging in the 2 arms were comparable, however more N3 patients in the 3FL arm (10.5%, 21/200) than that in the 2FL arm (10%, 5/200), P = 0040. Consequently, less TNM staging I patients in the 3FL arm (16.0%, 32/200) than that in the 2FL arm (25.5%, 51/200), P = 0.019. Operating time was significantly longer in the 3FL arm (median, 183 vs. 168 [2FL] minutes, P < 0.001). Six patients in the 3FL arm (3%, 6/200) had reintubation, whereas no reintubation in the 2 FL arm (0%, 0/200), P = 0.030. Other postoperative complications were comparable in the 2 arms. One patient in the 2-field arm died of chyloperitoneum. According to the Clavien-Dindo classification of surgical complications, the distribution of severity were similar between the 2 arms, P = 0.416. More lymph nodes were resected in the 3FL arm (Median, 37 vs. 24 [2FL], P < 0.001). Lymph nodes resected in the mediastinum and upper abdomen were comparable between the 2 arms. 44 patients (22%) in the 3FL arm had positive lymph nodes. Conclusion Compared with 2-field lymphadenectomy, 3-field lymphadenectomy doesn’t increase the surgical risks for patients with thoracic esophageal cancer. 3-field lymphadenectomy can be performed safely, removing unforeseen cervical positive lymph node, and offering more accurate tumor staging. Long-term survival analysis under protocol will clarify the role of 3-field lymphadenectomy for esophageal cancer. Disclosure All authors have declared no conflicts of interest.

Management of oesophageal anastomosis dehiscence after oesophagectomy for oesophageal cancer

2020 ◽  
Vol 99 (5) ◽  
pp. 200-206
Keyword(s):  
Oesophageal Cancer ◽  
Surgical Procedure ◽  
Anastomotic Dehiscence ◽  
Gastric Conduit ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Therapeutic Algorithm

Oesophagectomy is being used in treatment of several oesophageal diseases, most commonly in treatment of oesophageal cancer. It is a major surgical procedure that may result in various complications. One of the most severe complications is anastomotic dehiscence between the gastric conduit and the oesophageal remnant. Anastomotic dehiscence after esophagectomy is directly linked to high morbidity and mortality. We propose a therapeutic algorithm of this complication based on published literature and our experience by retrospective evaluationof 164 patients who underwent oesophagectomy for oesophageal cancer. Anastomotic dehiscence was present in 29 cases.

New Technique of Lymphadenectomy along Left Recurrent Nerve for Thoracic Esophageal Cancer

2013 ◽  
Vol 64 (2) ◽  
pp. 113-113
Author(s):  
E. Nagai ◽  
K. Nakata ◽  
K. Ohuchida ◽  
R. Maeyama ◽  
S. Shimizu ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
New Technique ◽  
Recurrent Nerve ◽  
Thoracic Esophageal Cancer

Swallowing Function-preserving Surgery for Thoracic Esophageal Cancer

2008 ◽  
Vol 59 (2) ◽  
pp. 213-213
Author(s):  
M. Yano ◽  
K. Takachi ◽  
K. Kishi ◽  
I. Miyashiro ◽  
S. Noura ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Thoracic Esophageal Cancer ◽  
Swallowing Function

Surgical treatment of multiple primary hypopharyngeal cancer and thoracic esophageal cancer: a report of 7 cases

2010 ◽  
Vol 30 (9) ◽  
pp. 998-1001
Author(s):  
Cai-yun ZHANG ◽  
Shi-cai CHEN ◽  
Hong-liang ZHENG ◽  
Zhi-gang LI ◽  
Min-hui ZHU ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Surgical Treatment ◽  
Hypopharyngeal Cancer ◽  
Thoracic Esophageal Cancer ◽  
Multiple Primary

scholarly journals Preparation and Pharmacokinetic Study of Daidzein Long-Circulating Liposomes

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Qiao Wang ◽  
Wenjin Liu ◽  
Junjun Wang ◽  
Hong Liu ◽  
Yong Chen
Keyword(s):  
Single Dose ◽  
Drug Concentration ◽  
Drug Loading ◽  
Plasma Drug Concentration ◽  
The Body ◽  
Molar Ratio ◽  
Terminal Phase ◽  
Plasma Drug ◽  
Ultrasonic Time ◽  
Time Required

Abstract In this study, daidzein long-circulating liposomes (DLCL) were prepared using the ultrasonication and lipid film-hydration method. The optimized preparation conditions by the orthogonal design was as follows: 55 to 40 for the molar ratio of soybean phosphatidylcholine (SPC) to cholesterol, 1 to 10 for the mass ratio of daidzein to total lipid (SPC and cholesterol) (w:w), the indicated concentration of 5% DSPE-mPEG2000 (w:w), 50 °C for the hydration temperature, and 24 min for the ultrasonic time. Under these conditions, the encapsulation efficiency and drug loading of DLCL were 85.3 ± 3.6% and 8.2 ± 1.4%, respectively. The complete release times of DLCL in the medium of pH 1.2 and pH 6.9 increased by four- and twofold of that of free drugs, respectively. After rats were orally administered, a single dose of daidzein (30 mg/kg) and DLCL (containing equal dose of daidzein), respectively, and the MRT0−t (mean residence time, which is the time required for the elimination of 63.2% of drug in the body), t1/2 (the elimination half-life, which is the time required to halve the plasma drug concentration of the terminal phase), and AUC0−t (the area under the plasma drug concentration-time curve, which represents the total absorption after a single dose and reflects the drug absorption degree) of daidzein in DLCL group, increased by 1.6-, 1.8- and 2.5-fold as compared with those in the free group daidzein. Our results indicated that DLCL could not only reduce the first-pass effect of daidzein to promote its oral absorption, but also prolong its mean resident time to achieve the slow-release effect.

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