Long term survival outcomes of surgery combined with hyperthermic intraperitoneal chemotherapy for perforated low-grade appendiceal mucinous neoplasms: A multicenter retrospective study.

BACKGROUND: Low-grade appendiceal mucinous neoplasms (LAMN) are very rare, accounting for approximately 0.2%-0.5% of gastrointestinal tumors. We conducted a multicenter retrospective study to explore the impact of different surgical procedures combined with HIPEC on the short-term outcomes and long-term survival of patients. METHODS: We retrospectively analyzed the clinicopathological data of 91 LAMN perforation patients from 9 teaching hospitals over a 10-year period, and divided them into HIPEC group and non-HIPEC group based on whether or not underwent HIPEC. RESULTS: Of the 91 patients with LAMN, 52 were in the HIPEC group and 39 in the non-HIPEC group. The Kaplan-Meier method predicted that 52 patients in the HIPEC group had 5- and 10-year overall survival rates of 82.7% and 76.9%, respectively, compared with predicted survival rates of 51.3% and 46.2% for the 39 patients in the non-HIPEC group, with a statistically significant difference between the two groups (χ2 = 10.622, p = 0.001; χ2 = 10.995, p = 0.001). Compared to the 5-year and 10-year relapse-free survival rates of 75.0% and 65.4% in the HIPEC group, respectively, the 5-year and 10-year relapse-free survival rates of 48.7% and 46.2% in the non-HIPEC group were significant different between the two outcomes (χ2 = 8.063, p = 0.005; χ2 = 6.775, p = 0.009). The incidence of postoperative electrolyte disturbances and hypoalbuminemia was significantly higher in the HIPEC group than in the non-HIPEC group (p = 0.023; p = 0.044). CONCLUSIONS: This study shows that surgery combined with HIPEC can significantly improve 5-year and 10-year overall survival rates and relapse-free survival rates of LAMN perforation patients, without affecting their short-term clinical outcomes.

Diagnosis and treatment of chylous leakage after modified radical mastectomy for breast cancer: a case report.

The post-operative complication of chylous leakage after breast cancer is relatively rare, and few clinical studies have been published. We report a 64-year-old woman with chylous leakage following modified radical mastectomy. We describe the patient's diagnostic and treatment process in detail. The patient was diagnosed with grade II (left) breast invasive ductal carcinoma. Post-operatively, the patient's chest wall and axilla were pressurized, and negative pressure drainage was initiated. On the fifth post-operative day, the drainage from the chest wall and axilla increased significantly, and the patient developed chylous leakage on the eighth postoperative day. We injected meglumine diatrizoate (100 mL) and elemene (10 mL) into the patient's axilla, and the chylous leakage gradually resolved 18 days post-operatively. In this report, we focus on managing a case of chylous leakage after modified radical mastectomy for breast cancer. Meglumine diatrizoate combined with elemene is a possible treatment for the management of this rare complication.

Single-solute and bi-solute sorption of phenanthrene and dibutyl phthalate by plant- and manure-derived biochars.

The spatial arrangement of biochar and the exact underlying interaction mechanisms of biochar and hydrophobic organic compounds both remain largely unknown. The sorption of dibutyl phthalate (DBP) and phenanthrene (PHE) to plant- and manure-derived biochars in both single- and bi-solute systems was investigated. The significant positive relation between surface polarity and ash content suggests that minerals benefit the external distribution of polar groups on particle surfaces. PHE and DBP sorption by the biochars was regulated by their surface polarity. The PHE generally displayed a pronounced enhancement of DBP sorption, likely resulting from the formation of biochar-PHE-DBP complexes, suggesting that DBP and PHE had different sorption sites on the biochars. The enhancement of Cd(2+) (a soft Lewis acid) on DBP sorption implied that π-π interactions should not dominate DBP sorption by biochars. The influence of Cd(2+) on PHE sorption by biochars would depend on the balance between suppressive sorption by Cd(2+)PHE bonding and enhanced sorption by Cd(2+)-complexed functionalities, and the amounts of Cd(2+) adsorbed by biochars determined the relative role of increased sorption by Cd(2+) in the overall PHE sorption.