Objective:To evaluate the surgical indications and postoperative morbidity of pharyngogastric anastomosis or pharyngocolonic anastomosis in esophageal reconstruction for advanced hypopharyngeal and cervical esophageal neoplasms or diffuse corrosive hypopharyngoesophageal stricture.Method:Retrospectively analysis the experience and results of 52 patients undergoing esophageal reconstruction with pharyngogastric anastomosis and 66 patients with pharyngocolonic anastomosis. In the group of neoplasms, total esophagectomy with pharyngo-gastric anastomoses in 52 cases and with pharyngo-colonic anastomosis in 35 cases. Thirty-one cases with diffuse corrosive hypopharyngoesophageal stricture were treated by pharyngo-colonic anastomosis without resection of the strictured intrathoracic esophagus.Result:In the group of neoplasms, preservation of laryngeal functions in pharyngogastric anastomoses was performed in 28/52 cases and that of in pharyngo-colonic anastomosis was in 18/35 cases. There was no significant difference in preservation of laryngeal functions between two groups(P>0.05). Pharyngocutanuous fistula was happened in 23 patients which significant higher in the group of pharyngocolonic anastomosis (17/66 cases) than that of pharyngogastric anastomoses (5/52 cases) (P<0.05). Gastric reflux was presented in 19 cases and there was significant higher in pharyngogastric anastomoses(16/52 cases) than that of(3/66 cases) (P<0.05).Conclusion:Substitution of esophagus with stomach or colon can completely removed the neoplasms of hypopharynx or cervical esophagus and preserved laryngeal functions in selected patients. But gastric reflux is a challenging reconstructive problem in pharyngogastric anastomosis. Pharyngocolonic anastomosis should take into consideration to patients with extensive neoplasms and diffuse corrosive stricture or probably preserved the laryngeal functions. However, the swallow function is weak and the incidence of pharyngocolonic fistula is higher than that of pharyngogastric anastomosis.

AIM: To confirm that CD4~+CD25~+ regulatory T cells don't have an instinctive defection in IL-2 secretion, and to have an insight into the maturation state of CD4~+CD25~+ T cells in cord blood. METHODS: CD4~+CD25~+ and CD4~+CD25~- T cells were purified from cord blood of term infants (CB) and adult peripheral blood (PB) by autoMACS, and stimulated with PDB plus ionomycin. After 45 hours of culture, cells were detected for expression of CD69 and CD25 by flow cytometry, and the supernatants were measured for 7 kinds of cytokines by Luminex. RESULTS: CD4~+CD25~+ T cells from both CB and PB proliferated comparably with CD4~+CD25~- T cells when stimulated with PDB plus ionomycin. After 45 hours of culture, however, the CD4~+CD25~+ T cells underwent a tendency of cell death. Expression of CD25 was further upregulated when CD25~+ cells were activated. Under stimulation of PDB plus ionomycin, both CD4~+CD25~+ and CD4~+CD25~- T cells in PB secreted high levels of IFN-?, IL-2 and TNF-?, with CD25~+ cells secreted much higher level of IL-5, IL-4 and IL-10 than those in CD25~- cells; CD4~+CD25~+ and CD4~+CD25~- T cells in CB also secreted high level of IL-2 and TNF-? but much lower level of IFN-? than those in PB, and no secretion of IL-5, IL-4 and IL-10 was observed. CONCLUSION: CD4~+CD25~+ regulatory T cells don't have an instinctive defection in IL-2 secretion, otherwise there may be a different TCR signaling pattern in CD4~+CD25~+ T cells from traditional T cells. The CD4~+CD25~+ T cells in cord blood have not fully matured in function.

OBJECTIVE: To evaluate the surgical indications and postoperative morbidity of pharyngogastric anastomosis or pharyngocolonic anastomosis in esophageal reconstruction for advanced hypopharyngeal and cervical esophageal neoplasms or diffuse corrosive hypopharyngoesophageal stricture. METHOD: Retrospectively analysis the experience and results of 52 patients undergoing esophageal reconstruction with pharyngogastric anastomosis and 66 patients with pharyngocolonic anastomosis. In the group of neoplasms, total esophagectomy with pharyngogastric anastomoses in 52 cases and with pharyngo-colonic anastomosis in 35 cases. Thirty-one cases with diffuse corrosive hypopharyngoesophageal stricture were treated by pharyngo-colonic anastomosis without resection of the strictured intrathoracic esophagus. RESULT: In the group of neoplasm E, preservation of laryngeal functions in pharyngogastric anastomoses was performed in 28/52 cases and that of in pharyngo-colonic anastomosis was in 18/35 cases. There was no significant difference in preservation of laryngeal functions between two groups (P > 0.05). Pharyngocutaneous fistula was happened in 23 patients which significant higher in the group of pharyngocolonic anastomosis (17/66 cases) than that of pharynogogastric anasromoses (5/52 cases) (P < 0.05). Gastric reflux was presented in 19 cases and there was significant higher in pharyngogastric anastomoses (16/52 cases) than that of (3/66 cases) (P < 0.05). CONCLUSION Substitution of esophagus with stomach or colon can completely removed the neoplasms of hypopharynx or cervical esophagus and preserved laryngeal functions in selected patients. But gastric reflux is a challenging reconstructive problem in pharyngogastric anastomosis. Pharyngocolonic anastomosis should take into consideration to patients with extensive neoplasms and diffuse corrosive stricture or probably preserved the laryngeal functions. However, the swallow function is weak and the incidence of pharyngocolonic fistula is higher than that of pharyngogastric anastomosis.
Adult ; Aged ; Anastomosis, Surgical ; Colon ; surgery ; Esophageal Neoplasms ; surgery ; Esophageal Stenosis ; Esophagoplasty ; methods ; Female ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Stomach ; surgery