Diaphragmatic suture with tubular stomach to prevent early delayed gastric emptying after esophagectomy

Objective The objective of this study was to evaluate the clinical efficacy of a diaphragmatic suture with tubular stomach to prevent delayed gastric emptying(DGE) after esophagectomy through the cervico-thoracoabdominal approach. Methods A total of 980 patients with esophageal cancer undergoing esophagectomy through the cervico-thoracoabdominal approach were retrospectively included in this study and divided into two groups. All patients underwent tubular stomach creation(group A; n = 530) or a diaphragmatic suture and tubular stomach creation(group B; n = 450). The incidence of early DGE was observed. Results The incidence of early DGE in group A was significantly higher than that in group B(P < 0.05). Conclusion This observation study suggests that the use of a diaphragmatic suture with tubular stomach through the cervico-thoracoabdominal approach can decrease the incidence of early DGE after esophagectomy.

Peripheral primitive neuroectodermal tumor of the posterior mediastinum: A case report

Peripheral primitive neuroectodermal tumor(pPNET) is an extremely rare disease entity of malignant tumors belonging to the Ewing sarcoma family that usually occurs in children and adolescents. We describe a 41-year-old female who presented with right upper abdominal pain. Surgical resection and biopsy revealed small round-cell tumor. Combined with immunohistochemical analysis, pPNET was diagnosed. No evidence of recurrence was noted at 18 months postoperatively. Even thought pPNET is a highly malignant tumor, Wide tumor-free resection and multi-agent chemotherapy can also obtain good clinical outcomes.

Experience with the surgical treatment of patients with both esophageal carcinoma and bullous emphysema

Objective： We aimed to investigate the security and feasibility of the simultaneous surgery for patients with both esophageal carcinoma and bullous emphysema. Methods： We described simultaneous surgery performed on 49 cases with both esophaoeal carcinoma and buUous emphysema, accounting for 2.5% of all esophagectomy patients from January 2000 to January 2003. Radical resection of upper and mid-thoracic esophageal cancer was performed in 31 cases, including three approaches from the right chest, left neck and midsection. Thirty-six patients were underwent cervical anastomosis and 13 cases were operated by intrathoracic anastomosis. Results： No perioperative period death occurred. And postoperative com- plications were as follows： cervical anastomotic leakage in 9 cases, lung infection in 11 cases, pulmonary air leak in 13 cases （2 cases lasted for 4 weeks）, recurrent laryngeal nerve damage in 4 cases, supraventricular tachycardia in 4 cases. Patients all recovered and left the hospital with average hospitalization time of 17.5 days. Conclusion： Patients with both esophageal carcinoma and bullous can perform the esophageal carcinoma resection and lung volume reduction surgery （LVRS） simulta- neously. It will not increase the mortality rate and show the feasibility and safety in patients.

Clinical and immune response characteristics among vaccinated persons infected with SARS-CoV-2 delta variant:a retrospective study

Objective:This study aimed to observe the clinical and immune response characteristics of vaccinated persons infected with the delta variant of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)in Yangzhou,China.Methods:We extracted the medical data of 129 patients with delta-variant infection who were admitted to Northern Jiangsu People’s Hospital(Yangzhou,China)between August and September,2021.The patients were grouped according to the number of vaccine doses received into an unvaccinated group:a one-dose group and a two-dose group.The vaccine used was SARS-CoV-2-inactivated vaccine developed by Sinovac.We retrospectively analyzed the patients’epidemiological,clinical,laboratory,and imaging data.Results:Almost all patients with delta-variant infection in Yangzhou were elderly,and patients with severe/critical illness were over 70 years of age.The rates of severe/critical illness(P=0.006),fever(P=0.025),and dyspnea(P=0.045)were lower in the two-dose group than in the unvaccinated group.Compared to the unvaccinated group,the two-dose group showed significantly higher lymphocyte counts and significantly lower levels of C-reactive protein(CRP),interleukin-6(IL-6),and D-dimer during hospitalization and a significantly higher positive rate of immunoglobulin G(IgG)antibodies at admission(all P<0.05).The cumulative probabilities of hospital discharge and negative virus conversion were also higher in the two-dose group than in the unvaccinated group(P<0.05).Conclusions:Two doses of the SARS-CoV-2-inactivated vaccine were highly effective at limiting symptomatic disease and reducing immune response,while a single dose did not seem to be effective.