ABSTRACT
In recent years, the incidence of adenocarcinoma of esophagogastric junction (AEG) keeps increasing. Siewert type II and type III AEG invades at 2-4 cm in the lower esophagus, and it has a higher rate of lower mediastinal lymph node metastasis. Lower mediastinal lymph node clearing through the abdomino-transhiatal (TH) approach is preferred, which can be accomplished by entering the lower mediastinum through the hiatus and mobilize the esophagus upward and the surrounding lymph and connective tissue for approximately 6.5 cm. Using the infracardiac bursa (IBC) as an anatomical landmark improves the safety and operability of the thorough dissection of the lower mediastinum. Total resection of the mesenterium at the esophagogastric junction can entirely dissect the lower mediastinal lymph nodes, which conforms to the safety principles in oncology.
ABSTRACT
Objective To study the diagnostic value of computed tomographic virtual endoscopy versus electronic colonoscopy for colon cancer in elderly patients.Methods The 69 cases of elderly patients with colon cancer received CTVE and electronic colonoscopy before surgery to compare achievement rates,sensitivities,and endoscopy coincidence rate with pathologic classification between the two methods.Results For a definite diagnosis of colon cancer in elderly patients,achievement ratio was 98.6％ (68/69) in CTVE and 62.3％ (43/69) in electronic colonoscopy(x2 =14.72,P＜ 0.05);sensitivity was 95.6％ (65/68) in CTVE and 97.7％ (42/43) in electronic eolonoscopy(x2=0.003,P ＞ 0.05);endoscopy coincidence rate with pathologic classification was 95.4％ (62/65) in C-TVE and 95.2％(40/42) in electronic colonoscopy.Conclusions CT virtual endoscopy may be one of examination methods in elderly patients with colon cancer.
ABSTRACT
Objective To study the imaging findings of disseminated pulmonary tuberculosis in patients with acquired immunodeficiency syndrome (AIDS).Methods X-ray and multi-slice CT (MSCT)data from 33 AIDS patients with disseminated pulnonary tuberculosis confirmed by clinical manifestations and laboratory tests were analyzed retrospectively.Results Thirty patients underwent initial chest radiography examination,29 patients showed abnormal appearances,including bilateral disseminations in 21 patients and unilateral multiple disseminations in 8 patients.All patients underwent MSCT examination,26 patients showed bilateral disseminations and 7 patients showed unilateral multiple disseminations.The abnormal pulmonary appearances included nodule (n =25),miliary nodule (n =22),air-space consolidation (n =22),cavity (n =11),fibrosis (n =7),ground-glass opacity (n =7),pneumatocele (n =4),calcification (n =2).There were 20 patients with more than 3 abnormal appearances and 13 patients with one or two abnormal appearances.The extra-pulmonary tuberculosis included pleural effusion (n =33),lymphadenopathy (n =30),intestinal tuberculosis (n =3),splenic tuberculosis (n =1) and cerebral tuberculosis (n =1).Conclusion Disseminated pulmonary tuberculosis should be highly suspected in AIDS patients with diffused nodules,miliary nodules,air-space consolidations or multiple cavities,accompanied with pleural effusion and lymphadenopathy.