OBJECTIVETo evaluate the long-term survival of multidisciplinary treatment based on thoracic surgery for cervical esophageal squamous cell carcinoma.

METHODSThe clinical characters and follow-up data of forty-one cervical esophageal cancer patients who accepted multidisciplinary treatment based on surgery with preservation of pharynx and larynx were retrospectively reviewed, and the long-term survival was compared with 480 non-cervical esophageal cancers who accepted surgery in the same period done by the same surgical team.

RESULTSThere were 28 males and 13 females with a mean age of 62 years old. In the cervical esophageal cancer group, 30 patients accepted neoadjuvant chemotherapy, 25 patients accepted adjuvant chemotherapy, and 21 patients accepted both. Six patients received postoperative radiation. Four patients underwent exploratory surgery alone, and 37 cases underwent radical surgery and cervical anastomosis. One case died during the perioperative period. The 1-, 3-, 5- and 8-year survival rates were 96.8%, 52.6%, 35.1%, and 35.1% in the 36 patients with cervical esophageal cancer who underwent radical surgery, and were 85.0%, 54.3%, 45.0%, and 36.7% respectively in the 457 non-cervical esophageal cancer patients. There was no significant difference between the cervical group and non-cervical group(P=0.91).

CONCLUSIONCervical esophageal cancer should be treated in a multidisciplinary approach to obtain satisfactory long-term outcomes.

Combined Modality Therapy ; Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Female ; Follow-Up Studies ; Humans ; Larynx ; surgery ; Male ; Middle Aged ; Pharynx ; surgery ; Retrospective Studies ; Treatment Outcome

Purpose: Surgical site infections (SSIs) remain a concern after implant-based breast reconstruction, despite preventive measures. These infections can have serious consequences. This study evaluated the correlation between drain tip culture results and SSIs in this patient population. Methods: We analyzed data from patients who underwent implant-based breast reconstruction between July 2021 and May 2023. Drain tip cultures were collected, and any SSIs occurring within one month of surgery were documented. We then compared clinical data with the culture results. Results: A total of 263 drain tip cultures were included. Notably, none of the 61 patients who underwent tissue expander removal and implant insertion had positive cultures. However, among the 202 patients who received tissue expanders or direct-to-implant procedures, 11 (5.45%) had positive cultures, with a total of 12 SSIs identified. Importantly, five of the 11 culture-positive wounds developed SSIs. Multivariate analysis revealed a significant two-way association between infection and positive drain tip cultures. For Staphylococcus aureus specifically, drain tip cultures showed excellent predictive value: sensitivity (33.33%), specificity (100%), positive predictive value (100%), and negative predictive value (95.96%). Conclusion Drain tip cultures from immediate implant-based breast reconstructions significantly correlated with SSIs. Close monitoring is crucial, especially when S. aureus is identified in the culture.

Purpose: Surgical site infections (SSIs) remain a concern after implant-based breast reconstruction, despite preventive measures. These infections can have serious consequences. This study evaluated the correlation between drain tip culture results and SSIs in this patient population. Methods: We analyzed data from patients who underwent implant-based breast reconstruction between July 2021 and May 2023. Drain tip cultures were collected, and any SSIs occurring within one month of surgery were documented. We then compared clinical data with the culture results. Results: A total of 263 drain tip cultures were included. Notably, none of the 61 patients who underwent tissue expander removal and implant insertion had positive cultures. However, among the 202 patients who received tissue expanders or direct-to-implant procedures, 11 (5.45%) had positive cultures, with a total of 12 SSIs identified. Importantly, five of the 11 culture-positive wounds developed SSIs. Multivariate analysis revealed a significant two-way association between infection and positive drain tip cultures. For Staphylococcus aureus specifically, drain tip cultures showed excellent predictive value: sensitivity (33.33%), specificity (100%), positive predictive value (100%), and negative predictive value (95.96%). Conclusion Drain tip cultures from immediate implant-based breast reconstructions significantly correlated with SSIs. Close monitoring is crucial, especially when S. aureus is identified in the culture.

Purpose: Surgical site infections (SSIs) remain a concern after implant-based breast reconstruction, despite preventive measures. These infections can have serious consequences. This study evaluated the correlation between drain tip culture results and SSIs in this patient population. Methods: We analyzed data from patients who underwent implant-based breast reconstruction between July 2021 and May 2023. Drain tip cultures were collected, and any SSIs occurring within one month of surgery were documented. We then compared clinical data with the culture results. Results: A total of 263 drain tip cultures were included. Notably, none of the 61 patients who underwent tissue expander removal and implant insertion had positive cultures. However, among the 202 patients who received tissue expanders or direct-to-implant procedures, 11 (5.45%) had positive cultures, with a total of 12 SSIs identified. Importantly, five of the 11 culture-positive wounds developed SSIs. Multivariate analysis revealed a significant two-way association between infection and positive drain tip cultures. For Staphylococcus aureus specifically, drain tip cultures showed excellent predictive value: sensitivity (33.33%), specificity (100%), positive predictive value (100%), and negative predictive value (95.96%). Conclusion Drain tip cultures from immediate implant-based breast reconstructions significantly correlated with SSIs. Close monitoring is crucial, especially when S. aureus is identified in the culture.

Purpose: Surgical site infections (SSIs) remain a concern after implant-based breast reconstruction, despite preventive measures. These infections can have serious consequences. This study evaluated the correlation between drain tip culture results and SSIs in this patient population. Methods: We analyzed data from patients who underwent implant-based breast reconstruction between July 2021 and May 2023. Drain tip cultures were collected, and any SSIs occurring within one month of surgery were documented. We then compared clinical data with the culture results. Results: A total of 263 drain tip cultures were included. Notably, none of the 61 patients who underwent tissue expander removal and implant insertion had positive cultures. However, among the 202 patients who received tissue expanders or direct-to-implant procedures, 11 (5.45%) had positive cultures, with a total of 12 SSIs identified. Importantly, five of the 11 culture-positive wounds developed SSIs. Multivariate analysis revealed a significant two-way association between infection and positive drain tip cultures. For Staphylococcus aureus specifically, drain tip cultures showed excellent predictive value: sensitivity (33.33%), specificity (100%), positive predictive value (100%), and negative predictive value (95.96%). Conclusion Drain tip cultures from immediate implant-based breast reconstructions significantly correlated with SSIs. Close monitoring is crucial, especially when S. aureus is identified in the culture.

OBJECTIVETo evaluate the long-term efficacy of transhiatal esophagectomy (THE) for esophageal carcinoma or esophagogastric junction cancer.

METHODSBetween March 2000 and December 2009, a total of 544 patients with either esophageal carcinoma or esophagogastric junction cancer underwent esophagectomy via THE (n=63) or other approaches (n=481) in Beijing cancer hospital institution. Procedures were performed by a single surgeon team. Long-term survival was compared between two groups.

RESULTSThe 1-year, 3-year, 5-year, and 8-year accumulative survival rates in THE group were 91.0%, 60.5%, 44.6%, and 44.6%, respectively, while those in non-THE group were 84.5%, 49.2%, 37.2%, and 28.7%, respectively. The THE group showed better long-term survival than the non-THE group, however the difference was not statistically significant.

CONCLUSIONTHE is a safe alternative for esophageal carcinoma and esophagogastric junction cancer.

Carcinoma ; surgery ; Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Esophagogastric Junction ; surgery ; Female ; Humans ; Male ; Middle Aged ; Stomach Neoplasms ; surgery ; Survival Rate ; Treatment Outcome

OBJECTIVETo explore the management strategies and outcome of treatment for multi-focal esophageal carcinoma.

METHODSTwenty two patients with multi-focal esophageal carcinoma who underwent esophagectomy by a single surgeon team from March 2000 to March 2011 at the Beijing Cancer Hospital were reviewed retrospectively. The clinical and pathological characters were analyzed, and the outcome was compared with that of 471 patients with single esophageal carcinoma who received esophagectomy by the same surgeon team during the same period.

RESULTSEighteen out of 22 patients with multi-focal esophageal cancer underwent esophagectomy via transthoracic approach while 4 patients via transhiatal. Eight patients received neoadjuvant chemotherapy and 15 patients received adjuvant chemotherapy. Four hundred and seventy-one out of 471 patients with single esophageal cancer underwent esophagectomy via transthoracic approach while 60 patients via transhiatal. One hundred and fourty-eight patients received neoadjuvant chemotherapy and 267 patients received adjuvant chemotherapy. The 3-year survival of the 22 patients with multi-focal esophageal carcinoma was 41.9%, and the median survival time was 29.2 months. The 3-year survival of the 471 patients with single esophageal carcinoma was 54.7%, and the median survival time was 46.8 months. There was no significant difference in survival between the two groups(P=0.051).

CONCLUSIONSThe prognosis of patients with multi-focal occurrence esophageal carcinoma was poor. Extended esophageal resection may be beneficial to these patients with concurrent systemic chemotherapy.

Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Esophageal Neoplasms ; surgery ; therapy ; Female ; Humans ; Male ; Middle Aged ; Neoplasms, Multiple Primary ; surgery ; therapy ; Retrospective Studies ; Treatment Outcome

Chinese Pharmacopoeia provides nine pesticide Maximum Residual Limits(MRLs) of traditional Chinese medicines(TCMs), The number of pesticides used in production are far more than those listed in pharmacopoeia. The lack of the standards make it's hard to reflect the real situation of pesticide residues in TCMs correctly. The paper is aimed to analyze the data of pesticide residues in TCMs from 7 089 items in 140 reports, and judging the exceedance rate of pesticides in TCMs using the MRLs of European pharmacopoeia，which is widely accepted in many countries. The results show that：①Pesticide residues in 18 kinds of TCMs are higher than MRLs，while in 137 kinds are below MRLs, such as Atractylodis Macrocephalae Rhizoma, Menthae Haplocalycis Herba and Fritillariae Thunbergii Bulbus. The average exceedance rate of all TCMs is 1.72%. The average exceedance rates of organochlorine, organophosphorus and pyrethroid are 2.26%, 1.51%, 0.37%，respectively. ②The average exceedance rate of pesticides is 2.00%, and the exceedance rate is more than 5%, accounting for 8.33%, the exceedance rate is between 1%-5%, accounting for 18.75%. the exceedance rate is between 0%-1%, accounting for 18.75%. The remaining 29 kinds of pesticides were not exceeded, accounting for 60.42%.Some reports like Greenpeace's organization exaggerated the pesticide residues in TCMs.But the pesticide residue question is still worthy of attention, so we proposed to amend the Chinese Pharmacopoeia pesticide residues standards, to increase the pesticide species of traditional Chinese medicine in production on the basis of retaining the existing types of pesticide residues, to strengthen the system research of pesticide residues in TCMs, providing a basis for making standard and promoting import and export trade in TCMs.