1,720,995 research outputs found
Intrathoracic manifestations of cervical anastomotic leaks after transhiatal and transthoracic oesophagectomy
No full textNot Availabl
Early stage non-small-cell lung cancer: surgical implications of the new adenocarcinoma classification.
No full textEarly stage non-small-cell lung cancer: surgical implications of the new adenocarcinoma classification
Key Leaders’ Opinion on Peri-Operative Risk Factor and Therapeutic Strategy in Lung Cancer Surgery
No full textPerioperative care remains a hot and controversial issue to thoracic surgeons with their multidisciplinary teams in the current clinical practice of lung cancer surgery. A better understanding regarding a series of effective and simple risk factors will provide significant assistance to identify which patients should be considered at high surgical risk. Subsequently, an accurate and personalized treatment scheme based on these putative prognostic factors will be vital to prevent the morbidity risk, enhance the surgical tolerability, and limit the unfavorable survival. Each contributing author has a particular interest in the selected hot subjects of modern perioperative medicine in lung cancer surgery, including body composition, host immune-nutritional status, tumor spread through air spaces (STAS), conversion to thoracotomy, enhanced recovery after surgery (ERAS), elderly health care, protective ventilation, intraoperative fluid management, digital pleural drainage technology, lung ultrasonography, endoscopic intervention, etc. They have given their influential opinions by literature review, personal expertise, and outcome discussion from their works. In this way, this book can help the readers get a comprehensive scenario about the current research highlights of perioperative risk factor analysis and appropriate treatment options in lung cancer surger
Chemoradiotherapy followed by surgery versus surgery alone in esophageal cancer patients: is it time for additional evidence?
Get PDFRecent efforts to improve survival in patients with locally advanced esophageal carcinoma have combined both systemic and local therapy. However, the role of neoadjuvant chemoradiotherapy in technically operable IIa-III esophageal carcinoma is still unresolved
Multiple primary laryngotracheal adenoid cystic and left thyroid follicular carcinoma with right vocal cord paralysis: the crucial role of surgery
No full textPrimary tracheal tumors are rare, accounting for only 0.2% of all thoracic cancers. Adenoid cystic carcinoma (ACC) diagnosed in the trachea is very uncommon and its coexistence with second histologically distinct malignant tumors of he neck region has never been reported
A case of vomiting in an anorexic achalasic patient
No full textWernicke's encephalopathy is a neurological disorder caused by thiamine (vitamin B1) deficiency characterized by vertigo, ataxia, and mental confusion. Wernicke's encephalopathy has a causative association with alcoholism but recently there has been an increased prevalence also in other clinical conditions. In literature potentially fatal Wernicke's encephalopathy onset in an advanced achalasia has been previously reported only once. We describe for the first time an improvement of achalasic symptoms in a young patient affected by end-stage achalasia and anorexia nervosa (coming from ineffective Heller-Dor myotomy) after vitamin B1 supplementation. This case report suggest a potential positive impact of B1 supplementation on end-stage achalasic patients and requires systematic studies to confirm this observation
Prognostic grading after complete resection for thymic malignancies
No full textOBJECTIVE:
Despite the World Health Organization (WHO) and Masaoka classifications have been widely accepted as the main describers of prognosis determinants in thymic malignancies, so far, these have been considered independently from one another. We have reviewed our single-centre 40-year results after surgical treatment of thymic malignancies evaluating the inter-relationships between the clinical, surgical and pathological variables and investigating their prognostic impact in completely resected patients.
PATIENTS AND METHODS:
A surgical series of 347 patients was reviewed and, of these, 305 with complete resection enrolled. Long-term and disease-free survival (LTS, DFS) analyses were performed. Kaplan-Meir curves for WHO histotypes and Masaoka-stages were inspected and matched with the log-rank test; the Cox regression analysis was adopted in a multivariable approach.
RESULTS:
Considered independently, the WHO-histotypes did not differentiate clearly from one to another in terms of LTS and DFS; however, types A-AB-B1-B2 and B3-C clustered in 2, statistically different, malignancy groups (LTS, DFS: Cox-p < 0.001). Masaoka staging was confirmed to be a relevant prognostic determinant, even if no evident difference between stages I vs II and stages III vs IV emerged when the Masaoka-classification was factored in. Thus, when investigating 13 surgical and pathological factors of invasiveness, these showed a clustering in 2 groups according to the presence/absence of pathological proven infiltration in the peri-thymic structures (LTS, DFS: Cox-p < 0.001). By matching the WHO-malignancy clusters and infiltration clusters, 4 classes may be identified, which proved to have a distinct prognostic significance: (LTS-Cox: stage-I vs stage-II, p = 0.003; III: p < 0.001, IV: p < 0.001; DFS-Cox: stage-I vs stage-II, p < 0.001; III: p < 0.001; IV: p < 0.001).
CONCLUSIONS:
When analyzing the long-term outcome of patients underwent complete resection for thymic malignancies, the combination between pathological and surgical variables showed accurate prognosis predictabilit
- …
