ABSTRACT
Objective To investigate the value of ionic-contrast esophagogram in diagnosis of intrathoracic anastomotic leakage after oesophagectomy.Methods The data of 728 patients suffered esophagectomy were retrospectively collected.723 patients without clinical manifestations of anastomotic leakage were divided into group A(esophagogram before eating,n=465) and group B(non-esophagogram before eating,n=258).The incidence of anastomotic leakage was compared between the two groups.Results The discovery rates of anastomotic leakage in group A and B were 0.43%(2/465) and 0.78%(2/258),respectively,the difference was no statistically significant between the two group(P=0.55).The total incidence rates of anastomotic leakage in group A and B were 0.65%(3/465) and 0.78%(2/258),respectively,the difference was no statistically significant between the two groups(P=0.84).5 patients with clinically suspected anastomotic leakage,all had loculated pleural effusion,4 cases had fever,and 2 cases had abnormal chest drainage.Finally,4 cases(80%) were confirmed to be anastomotic leak by esophagogram.Conclusion Routine ionic-contrast esophagogram before eating do not improve intrathoracic anastomotic leakage detection rate after esophagectomy,but when patients have fever,loculated pleural effusion and abnormal chest drainage,esophagogram is necessary and can improve the detection rate of esophageal anastomotic leak.CT radiography may detect smaller anastomotic leakage than conventional esophagogram.
ABSTRACT
Objective To evaluate the effect of chest backplate in treating multiple rib fractures in patients with focal abnormal breathing.Methods The clinical data of 36 patients with multiple rib fractures and focal abnormal breathing who were treated by Chrisofix chest backplate were analyzed.Results Thirtyfour patients were cured by chest backplate and other conservative treatments,and 2 patients underwent rib internal fixation surgery.The numeric rating scales scores before and after the application of the chest backplate were (8.1 ± 0.7) scores and (5.2 ± 0.5) scores respectively(P ＜ 0.01).Seven patients had skin blisters forming around the shield,which were cured by liquid extraction with a syringe and gauze covered with povidone iodine.No patients stopped treatment because of allergy.Conclusions Chest backplate is an effective,easy and inexpensive method for patient with multiple rib fractures and focal abnormal breathing who doesn't need exploratory thoracotomy.It is worthy to spread in clinical treatment.
ABSTRACT
Objective To investigate the clinical significance of WDHD1 protein expression in esophageal squamous cell carcinoma.Methods The expression of WDHD1 protein in esophageal squamous cell carcinoma,adenocarcinoma of esophagus and normal esophagus tissues by immunohistochemical MaxVision was detected.Results The expression of WDHD1 protein in the tissues of esophageal squamous cell carcinoma was significantly higher than that in the normal esophagus tissues and adenocarcinoma of esophagus (15.68 ± 3.01 vs.3.89 ± 2.98 and 4.66 ± 2.46)(P ＜ 0.05),there was no significant between normal esophagus tissues and adenocarcinoma of esophagus (P ＞ 0.05).The expression of WDHD 1 protein in the tissues of esophageal squamous cell carcinoma,high-middle differentiation tissues was higher than poorly differentiation,TNM stage Ⅲ + Ⅳ stage was higher than Ⅰ + Ⅱ stage,depth of invasion T3 + T4 was higher than T1 + T2,with lymph node metastasis tissue was higher than without,differences was statistically significant (P ＜0.05).Conclusions The higher expression of WDHD1 protein is the marker of high invasive and low histological grade of esophageal squamous cell carcinoma,and WDHD1 in esophageal squamous cell carcinomas may play an important role in development.