OBJECTIVETo study the efficacy of pedicled greater omentum transposed to mediastinum in prevention against postoperative in-hospital intrathoracic complications after esophagectomy.

METHODSClinical data of 148 consecutive patients with esophageal cancer undergoing Ivor-Lewis surgery in our department from January 2010 to May 2014 were retrospectively reviewed. Among them, 84 patients with omental transposition(transposition group) and 64 patients without omental transposition(non-transposition group) were compared.

RESULTSPostoperative hospital stay was shorter in patients with omental transposition compared to those without omental transposition(P<0.05). Intrathoracic infection rate was significantly lower in transposition group(33/84, 39.3%) than that in non-transposition group(36/64, 56.2%), and as was the combined sepsis rate[19/33, 57.6% vs. 31/36, 86.1%, P<0.05]. No significant differences were found in the morbidity of anastomotic leakage, wound infection, cardiac complication and mortality during hospitalization. The median postoperative hospital stay was significantly shorter in transposition group than that in non-transposition group(13.0 vs. 16.5 days, P<0.05).

CONCLUSIONOmental transposition to mediastinum can reduce the development and severity of intrathoracic infection and shorten hospital stay in patients undergoing esophagectomy.

Anastomotic Leak ; Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Humans ; Mediastinum ; surgery ; Omentum ; transplantation ; Postoperative Complications ; prevention & control ; Retrospective Studies

Objective To study the efficacy of pedicled greater omentum transposed to mediastinum in prevention against postoperative in-hospital intrathoracic complications after esophagectomy. Methods Clinical data of 148 consecutive patients with esophageal cancer undergoing Ivor-Lewis surgery in our department from January 2010 to May 2014 were retrospectively reviewed. Among them, 84 patients with omental transposition (transposition group) and 64 patients without omental transposition(non-transposition group) were compared. Results Postoperative hospital stay was shorter in patients with omental transposition compared to those without omental transposition (P<0.05). Intrathoracic infection rate was significantly lower in transposition group (33/84, 39.3%) than that in non-transposition group(36/64, 56.2%), and as was the combined sepsis rate[19/33, 57.6%vs. 31/36, 86.1%, P<0.05]. No significant differences were found in the morbidity of anastomotic leakage , wound infection, cardiac complication and mortality during hospitalization. The median postoperative hospital stay was significantly shorter in transposition group than that in non-transposition group (13.0 vs. 16.5 days, P<0.05). Conclusion Omental transposition to mediastinum can reduce the development and severity of intrathoracic infection and shorten hospital stay in patients undergoing esophagectomy.

Objective To study the efficacy of pedicled greater omentum transposed to mediastinum in prevention against postoperative in-hospital intrathoracic complications after esophagectomy. Methods Clinical data of 148 consecutive patients with esophageal cancer undergoing Ivor-Lewis surgery in our department from January 2010 to May 2014 were retrospectively reviewed. Among them, 84 patients with omental transposition (transposition group) and 64 patients without omental transposition(non-transposition group) were compared. Results Postoperative hospital stay was shorter in patients with omental transposition compared to those without omental transposition (P<0.05). Intrathoracic infection rate was significantly lower in transposition group (33/84, 39.3%) than that in non-transposition group(36/64, 56.2%), and as was the combined sepsis rate[19/33, 57.6%vs. 31/36, 86.1%, P<0.05]. No significant differences were found in the morbidity of anastomotic leakage , wound infection, cardiac complication and mortality during hospitalization. The median postoperative hospital stay was significantly shorter in transposition group than that in non-transposition group (13.0 vs. 16.5 days, P<0.05). Conclusion Omental transposition to mediastinum can reduce the development and severity of intrathoracic infection and shorten hospital stay in patients undergoing esophagectomy.

Objective To investigate the prognostic evaluation value of the HALP score composed of hemoglobin,albumin,lymphocytes and platelets before chemotherapy in the patients with diffuse large B-cell lymphoma(DLBCL).Methods The clinical data and laboratory indicators before chemotherapy in the pa-tients with DLBCL newly diagnosed in this hospital from January 2015 to October 2022 were retrospectively analyzed.The optimal cut-off value of HALP was calculated by X-tile software.The patients were grouped ac-cording to the optimal cutoff value,the Chi-square test was used to analyze the difference in the constituent ra-tio of clinical characteristics among different HALP score groups,the survival curves of the progression-free survival(PFS)time and overall survival(OS)time among the groups with different scores were drawn by u-sing the Kaplan-Meier method,the Cox univariate and multivariate analysis regression model was adopted to analyze the prognostic influencing factors in DLBCL patients,and the predictive ability of HALP score for PFS time and OS time in DLBCL patients was evaluated by using the receiver operating characteristic(ROC)curve.Results A total of 132 patients with DLBCL were included,the optimal cutoff value of HALP score was 21.23 points.There were 54 cases in the low HALP score group and 78 cases in the high HALP score group.The low HALP score group was correlated with the later clinical stage,higher IPI and NCCN-IPI scores,higher LDH level and lower overall response rate(ORR)(P＜0.05).Compared to the high HALP score group,the PFS time and OS time in the low HALP score group were shorter(P＜0.05).The Cox uni-variate and multivariate regression model analysis results indicated that the HALP score≤21.23 points was an independent risk factor affecting the PFS time(HR=1.811,P=0.031).The ROC curve results suggested that the combination of HALP score combined with IPI score or NCCN-IPI score had higher predictive value for PFS time and OS time in DLBCL patients compared to use IPI or NCCN-IPI alone.Conclusion The HALP score is correlated with the prognosis of DLBCL patients,and could early identify the high-risk DLBCL patients with poor prognosis.The HALP score,IPI score and NCCN-IPI score combined evaluation has higher predictive value.

OBJECTIVE To observe the short-term efficacy and safety of venetoclax combined with homoharringtonine and cytarabine in the treatment of acute myeloid leukemia （AML）. METHODS The data of 40 newly diagnosed AML patients admitted to our hospital from October 2022 to November 2023 were retrospectively collected and divided into observation group and control group according to treatment plan， with 20 cases in each group. The patients in the control group were given Daunorubicin hydrochloride for injection+Cytarabine for injection， and the patients in the observation group were given Venetoclax tablets+ Homoharringtonine injection+Cytarabine for injection. The patients in both groups were given relevant medicine， with 28 days as one cycle. The short-term efficacy， negative rate of minimal residual disease （MRD）， duration of granulocyte deficiency， duration of platelet （PLT） ＜20×109 L－1， transfusion volume of suspended red blood cells and platelet， and the occurrence of adverse drug reactions were evaluated in both groups after 1 cycle of induction chemotherapy. RESULTS The complete remission or complete remission with incomplete hematologic recovery （CR/CRi） rate in the observation group was significantly higher than control group （P＜0.05）， and the negative rate of MRD in the observation group was also significantly higher than control group （P＜0.05）. However， in low-， medium- and high-risk patients， there was no statistical significance in CR/CRi rates between the two groups （P＞0.05）. There were no significant differences in the duration of agranulocytosis， the duration of PLT ＜20×109 L－1， the amount of suspended red blood cell transfusion， the amount of platelet transfusion， the incidence of hematologic toxicity and the incidence of non-hematologic toxicity between 2 groups （P＞0.05）. CONCLUSIONS Venetoclax combined with homoharringtonine and cytarabine show good short-term efficacy and safety in the treatment of AML.