1.The clinical application of central venous catheter for thoracic closed drainage after esophagectomy
Zongjun XIANG ; Jun PENG ; Jintao HE ; Bo XIAO ; Hao RONG ; Guangguo REN
Chinese Journal of Thoracic and Cardiovascular Surgery 2018;34(1):36-39
Objective To explore the safety and effectiveness of central venous catheter for thoracic drainage after esoph-agectomy.Methods We prospectively analyzed 95 patients who underwent esophagectomy for esophageal carcinoma in our de-partment from August 2016 to August 2017.Forty-six patients with central venous catheter drainage were observation group, and 49 patients with traditional chest-tube closed drainage were control group.Compared the differences of drainage amount, pain score, postoperative patient quality of life score, duration of drainage and chest tube incision healing between the two groups.Results There were no significant differences in daily drainage volume and patency of drainage tube between the two groups(P>0.05).Compared with the control group, the duration of thoracic drainage in the observation group was significant shorter, the pain intensity score was significant lower , and the emotional function of postoperative patient quality of life was sig-nificant better(P<0.01).There were more patients suffered uncomfortable symptoms, such as nausea, vomiting, pain, in-somnia in the control group(P<0.05).Conclusion The application of central venous catheter in thoracic drainage can de-crease the postoperative pain and improve the postoperative quality of life for esophageal carcinoma patients after esophagecto-my.It is safe and feasible for thoracic drainage after esophagectomy .
2.Preoperative inflammatory indexes are useful predictors of postoperative survival in patients with local-advanced esophageal squamous cell carcinoma
LI Xiaoming ; XIANG Zongjun ; WAN Zhiyu ; LU Yongguo ; MU Haide ; YIN Juntai
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2019;26(9):865-869
Objective To evaluate the prognostic value of preoperative inflammatory indexes in patients with local-advanced esophageal squamous cell carcinoma. Methods We retrospectively analyzed the clinical and prognostic data of 150 local-advanced esophageal squamous cell carcinoma patients who were treated by esophagectomy in Guangyuan Central Hospital from July 2014 to July 2015. There were 128 males and 22 females with average age of 62.23±8.48 years. The optimal cutoff value was determined by receiver operation characteristics (ROC) curve analysis. Patients were grouped according to the optimal cutoff values (NLR=3.49, PLR=152.28, MLR=0.36). Log-rank test, and multivariate Cox logistic regression modelling were used to assess the simultaneous influences of prognostic factors for survival outcomes after esophagectomy. Results The patients with higher ratio (NLR>3.49, PLR>152.28, MLR>0.36) had significantly shorter median progression free survival (PFS) and lower postoperative recurrent rate than those of the patients with lower ratio. The stratified analyses found that thelymph node staging and postoperative recurrent rate were positively correlated with the higher ratio. However, the tumor differentiation was negatively correlated with it. In univariate analyses, patients with preoperative NLR>3.49, PLR>152.28 and MLR>0.36 had a poorer prognosis. Furthermore, in multivariate analyses we found MLR>0.36 was also significantly associated with a decreased postoperative recurrent rate (HR=12.945, 95%CI 2.31 to 72.548, P=0.00). Conclusions The preoperative NLR, PLR and MLR are useful prognostic markers in patients with stage ⅢA-ⅣA esophageal squamous cell carcinoma who conducted esophagectomy.