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1.
Anticancer Res ; 41(1): 385-389, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33419835

RESUMO

BACKGROUND/AIM: A combination therapy of esophageal stent and chemoradiotherapy (CRT) is currently considered risky for severe complications. The aim of this study was to assess the safety and efficacy of a fully covered self-expandable metallic stent (FCSEMS) placement in palliating incurable esophageal cancer before and/or after CRT. PATIENTS AND METHODS: We retrospectively reviewed clinical outcomes of 64 incurable advanced esophageal cancer patients with FCSEMS placement. Forty-two of 64 patients had FCSEMS placement with RT. RESULTS: The rate of all of stent-related complications tended to be higher in patients who had RT, although no significant difference was observed. The stent-related deaths occurred in one patient due to hemorrhage after FCSEMS placement in the RT-negative group. CONCLUSION: Palliation of dysphagia or fistulas with FCSEMS in patients with incurable esophageal cancer before and/or after RT is not associated with an increased risk of life-threatening complications.


Assuntos
Transtornos de Deglutição/etiologia , Transtornos de Deglutição/terapia , Neoplasias Esofágicas/complicações , Cuidados Paliativos , Stents Metálicos Autoexpansíveis , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos/métodos , Prognóstico , Radioterapia , Stents Metálicos Autoexpansíveis/efeitos adversos , Análise de Sobrevida , Resultado do Tratamento
2.
Anticancer Res ; 41(1): 453-458, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33419843

RESUMO

BACKGROUND AND AIM: Anastomotic leakage, the most common major complication after esophagectomy, is an important early postoperative complication that results in reoperation, delayed discharge, and psychological and financial distress. The current study focused on gastric conduit blood flow and investigated the relationship between gastric conduit temperature and anastomotic leakage. PATIENTS AND METHODS: Between July 2015 and December 2017, a total of 51 patients aged 38 to 84 years who underwent esophagectomy followed by esophagogastric anastomosis with gastric conduit reconstruction were enrolled. Thermography was then used to measure the temperature of the intact stomach and gastric conduit before anastomosis. RESULTS: The temperature of the planned site of gastric conduit anastomosis was significantly inversely correlated with anastomotic leakage, with the receiver operator characteristic curve showing a cutoff point of 27.6°C for predicting anastomotic leakage. CONCLUSION: The temperature of the planned gastric tube anastomosis line should be kept at 27.6°C or higher to reduce anastomotic leakage.


Assuntos
Fístula Anastomótica/diagnóstico , Fístula Anastomótica/etiologia , Neoplasias Esofágicas/complicações , Esofagectomia/efeitos adversos , Complicações Pós-Operatórias/diagnóstico , Procedimentos Cirúrgicos Reconstrutivos , Estômago/cirurgia , Termografia , Adulto , Idoso , Idoso de 80 Anos ou mais , Temperatura Corporal , Neoplasias Esofágicas/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Prognóstico , Procedimentos Cirúrgicos Reconstrutivos/métodos , Estudos Retrospectivos , Termografia/métodos
3.
BMJ Case Rep ; 14(1)2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33408107

RESUMO

A 38-year-old male patient presented to the ear, nose and throat department with shortness of breath over last 2 months. The CT scan of the neck and chest revealed a 3.3×3 cm tumour behind the right thyroid lobe extending into the tracheo-oesophageal (TO) groove with tracheal compression. The ultrasound scan of the neck and targeted fine needle aspiration followed by core biopsy raised a suspicion of Hodgkin's lymphoma. The patient underwent a right hemithyroidectomy and incisional biopsy of the right TO groove tumour. The histology confirmed a Hasenclever's three nodular sclerosing Hodgkin's lymphoma for which he received adjuvant chemotherapy. An incidental pT1a pN0 thyroid papillary microcarcinoma in the adjacent thyroid parenchyma was completely excised. This represents a case of TO Hodgkin's lymphoma, of which there are no current published case reports. We aim to raise awareness about this rare condition by sharing the diagnostic work up and successful management in a multidisciplinary team setting.


Assuntos
Carcinoma Papilar/diagnóstico , Neoplasias Esofágicas/diagnóstico , Doença de Hodgkin/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Sons Respiratórios , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Traqueia/diagnóstico , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia com Agulha de Grande Calibre , Carcinoma Papilar/complicações , Carcinoma Papilar/patologia , Carcinoma Papilar/terapia , Quimioterapia Adjuvante , Diagnóstico Diferencial , Dispneia/etiologia , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/terapia , Esôfago/diagnóstico por imagem , Esôfago/patologia , Esôfago/cirurgia , Doença de Hodgkin/complicações , Doença de Hodgkin/patologia , Doença de Hodgkin/terapia , Humanos , Achados Incidentais , Masculino , Esvaziamento Cervical , Neoplasias Primárias Múltiplas/complicações , Neoplasias Primárias Múltiplas/patologia , Neoplasias Primárias Múltiplas/terapia , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/terapia , Tireoidectomia , Tomografia Computadorizada por Raios X , Neoplasias da Traqueia/complicações , Neoplasias da Traqueia/patologia , Neoplasias da Traqueia/cirurgia , Resultado do Tratamento , Ultrassonografia
4.
J Infect Chemother ; 27(1): 99-102, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33023821

RESUMO

We present three patients affected by pulmonary squamous cell carcinoma, metastatic esophageal cancer and advanced non-Hodgkin lymphoma, who incurred in coronavirus 2019 (COVID-19) infection during the early phase of epidemic wave in Italy. All patients presented with fever. Social contact with subject positive for COVID-19 was declared in only one of the three cases. In all cases, laboratory findings showed lymphopenia and elevated C-reactive protein (CRP). Chest x-ray and computed tomography showed bilateral ground-glass opacities, shadowing, interstitial abnormalities, and "crazy paving" pattern which evolved with superimposition of consolidations in one patient. All patients received antiviral therapy based on ritonavir and lopinavir, associated with hydroxychloroquine. Despite treatment, two patients with advanced cancers died after 39 and 17 days of hospitalization, while the patient with lung cancer was dismissed at home, in good conditions.


Assuntos
Infecções por Coronavirus/tratamento farmacológico , Hidroxicloroquina/uso terapêutico , Lopinavir/uso terapêutico , Neoplasias/complicações , Pneumonia Viral/tratamento farmacológico , Ritonavir/uso terapêutico , Idoso , Antibacterianos/uso terapêutico , Antivirais/uso terapêutico , Betacoronavirus , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/tratamento farmacológico , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Surtos de Doenças , Quimioterapia Combinada , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/tratamento farmacológico , Evolução Fatal , Humanos , Itália , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/tratamento farmacológico , Linfoma não Hodgkin/complicações , Linfoma não Hodgkin/diagnóstico , Linfoma não Hodgkin/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Neoplasias/diagnóstico , Neoplasias/tratamento farmacológico , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Tomografia Computadorizada por Raios X , Resultado do Tratamento
5.
Am J Surg ; 221(1): 149-154, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32594999

RESUMO

BACKGROUND: Systemic inflammation and low skeletal muscle volume (presarcopenia) have received increasing attention in many malignancies. However, their association and the combined effect on postoperative survival in esophageal cancer (EC) patients have been poorly studied. METHODS: Eighty-nine patients with EC who underwent surgery between 2006 and 2014 were included in this study. Neutrophil-to-lymphocyte ratio (NLR) ≥3.0 was categorized as having systemic inflammation. Presarcopenia was defined as a Skeletal muscle index (SMI) less than 52.4 cm2/m2 for men and less than 38.5 cm2/m2 for women. RESULTS: Multivariate analysis revealed that presarcopenia was an independent prognostic preoperative factor for overall survival (OS) (p = 0.004). Multivariate analysis for OS stratified by systemic inflammation revealed that presarcopenia with systemic inflammation (Hazard ratio(HR),20.70; 95% confidence interval (CI),1.34-318.90) was associated with nearly a seven-fold higher risk of death than those without systemic inflammation (HR, 2.94; 95%CI, 1.04-8.34). CONCLUSIONS: Systemic inflammation enhanced the effect of presarcopenia on the prognosis of EC patients. The combined assessment of those factors may have potential prognostic value for EC.


Assuntos
Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/mortalidade , Esofagectomia , Inflamação/complicações , Sarcopenia/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Esofágicas/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
6.
J Surg Res ; 257: 554-571, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32927322

RESUMO

BACKGROUND: To evaluate the existing literature comparing cardiopulmonary complications after minimally invasive esophagectomy (MIE) with open esophagectomy (OE) and conduct a meta-analysis based on the relevant studies. METHODS: A systematic search for articles was performed in Medline, Embase, Wiley Online Library, and the Cochrane Library. The relative risks or odds ratios (ORs) were calculated by using fixed or random-effects models. The I2 and X2 tests were used to test for statistical heterogeneity. We performed a metaregression for the pulmonary complications with the adenocarcinoma proportion and tumor stage. Publication bias and small-study effects were assessed using Egger's test and Begg's funnel plot. RESULTS: A total of 30,850 participants were enrolled in the 63 studies evaluated in the meta-analysis. Arrhythmia, pulmonary embolism, pulmonary complications, gastric tip necrosis, anastomotic leakage, and vocal cord palsy were chosen as outcomes. The occurrence rate of arrhythmia was significantly lower in patients receiving MIE than in patients receiving OE (OR = 0.69; 95% CI = 0.53-0.89), with heterogeneity (I2 = 30.7%, P = 0.067). The incidence of pulmonary complications was significantly lower in patients receiving MIE (OR = 0.54, 95% CI = 0.45-0.63) but heterogeneity remained (I2 = 72.1%, P = 0.000). The risk of gastric tip necrosis (OR = 1.48, 95% CI = 1.07-2.05) after OE was lower than that after MIE. Anastomotic leakage, pulmonary embolism, and vocal cord palsy showed no significant differences between the two groups. CONCLUSIONS: MIE has advantages over OE, especially in reducing the incidence of arrhythmia and pulmonary complications. Thus, MIE can be recommended as the preferred alternative surgery method for resectable esophageal cancer.


Assuntos
Neoplasias Esofágicas/cirurgia , Esofagectomia/efeitos adversos , Complicações Pós-Operatórias/etiologia , Fístula Anastomótica/etiologia , Arritmias Cardíacas/etiologia , Neoplasias Esofágicas/complicações , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos , Embolia Pulmonar/etiologia , Paralisia das Pregas Vocais/etiologia
7.
Gan To Kagaku Ryoho ; 47(9): 1359-1362, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-33130700

RESUMO

A 59-year-old female was referred to our hospital due to abnormal upper gastrointestinal(GI)findings in July 2019. Endoscopy showed an advanced type Ⅱ tumor at the esophagogastric junction. The bioptical diagnosis was adenocarcinoma. Computed tomography(CT)and positron emission tomography(PET)revealed a swollen lymph node and abnormal accumulation. Total gastrectomy and Roux-en-Y reconstruction were performed. The final diagnosis was esophagogastric junctional cancer and follicular lymphoma. The chance of encountering double cancer is likely to increase. It is vital to prioritize treatment and determine an appropriate treatment plan according to the clinical stage and prognosis in patients with double cancer.


Assuntos
Adenocarcinoma , Neoplasias Esofágicas , Linfoma Folicular , Neoplasias Gástricas , Adenocarcinoma/cirurgia , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/cirurgia , Junção Esofagogástrica/cirurgia , Feminino , Gastrectomia , Humanos , Linfoma Folicular/complicações , Linfoma Folicular/tratamento farmacológico , Linfoma Folicular/cirurgia , Pessoa de Meia-Idade , Neoplasias Gástricas/complicações , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/cirurgia
8.
Kyobu Geka ; 73(10): 876-882, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-33130783

RESUMO

The incidence of postoperative morbidity and mortality are higher in patients with preoperative malnutrition in esophageal cancer patients. Oral intake tends to decrease during preoperative chemotherapy, and nutritional status is likely to worsen. When nutrition intake decreases, catabolism increases and muscle mass can decrease. It has been reported that related to preoperative sarcopenia and the onset and prognosis of postoperative complications. It has been reported to be associated with preoperative sarcopenia and the incident of postoperative complications and prognosis. Early nutritional assessment and interventions should improve nutritional status before surgery. Amino acid intake and exercise therapy improve exercise capacity such as walking. It is expected that a synergistic effect on the improvement of long-term prognosis by nutrition therapy and exercise therapy. Our hospital has introduced a enhanced preoperative nutrition rehabilitation program for undernourished patients. Immuno-nutrition therapy, exercise therapy, and postexercise branched-chain amino acid preparations are administered. During surgery for such malnourished patient, it is necessary to minimize the surgical invasion and to avoid complications. It is important to have continuous nutritional evaluation, intervention and rehabilitation by various occupations from the initial diagnosis to the perioperative period as well as during outpatient follow-up after discharge.


Assuntos
Neoplasias Esofágicas , Avaliação Nutricional , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/cirurgia , Humanos , Estado Nutricional , Apoio Nutricional , Complicações Pós-Operatórias/prevenção & controle
9.
Ann Otol Rhinol Laryngol ; 129(12): 1243-1246, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32517491

RESUMO

OBJECTIVES: LMNA-associated familial partial lipodystrophy (FPLD) is a rare autosomal dominant A-type laminopathy characterized by variable loss and redistribution of subcutaneous adipose tissue, dyslipidemia, and insulin resistance. Though A-type lamins play a key role in nuclear membrane structure and regulation of cell proliferation, an association between cancer and LMNA-associated FPLD has not been reported. METHODS AND RESULTS: This report outlines the case of two biological sisters with LMNA-associated FPLD who developed hypopharyngeal squamous cell carcinoma in the absence of any other risk factors for head and neck cancer. CONCLUSION: These observations prompt further investigation into the potential role of A-type lamins in the development and progression of head and neck cancers.


Assuntos
Neoplasias Hipofaríngeas/complicações , Lipodistrofia Parcial Familiar/complicações , Irmãos , Carcinoma de Células Escamosas de Cabeça e Pescoço/complicações , Adulto , Quimiorradioterapia , Neoplasias Esofágicas/complicações , Carcinoma de Células Escamosas do Esôfago/complicações , Evolução Fatal , Feminino , Gastrostomia , Humanos , Neoplasias Hipofaríngeas/patologia , Neoplasias Hipofaríngeas/terapia , Lamina Tipo A/genética , Laringectomia , Lipodistrofia Parcial Familiar/genética , Faringectomia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , Traqueostomia
10.
Ann R Coll Surg Engl ; 102(9): e1-e3, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32513017

RESUMO

The impact of HIV/AIDS on the treatment of oesophageal neoplasms remains undefined due to a lack of adequate data. We present our experience in treating patients with HIV/AIDS who have oesophageal cancer using minimally invasive techniques and discuss important key factors during perioperative management. Two men with HIV/AIDS underwent minimally invasive oesophagectomies in our department, with adequate clinical and oncological outcomes. Minimally invasive oesophagectomy can be safe and has the well-established benefits of minimally invasive techniques, offering good perioperative results and oncological outcomes in patients with HIV/AIDS. Multimodality therapy is crucial.


Assuntos
Neoplasias Esofágicas/cirurgia , Esofagectomia/métodos , Infecções por HIV/complicações , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Idoso , Neoplasias Esofágicas/complicações , Humanos , Masculino , Pessoa de Meia-Idade
12.
Jpn J Clin Oncol ; 50(10): 1162-1167, 2020 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-32533160

RESUMO

BACKGROUND: Second primary head and neck cancers after endoscopic resection of esophageal squamous cell carcinoma adversely affect patients' outcomes and the quality of life; however, an adequate surveillance schedule remains unclear. METHODS: We analyzed 330 patients with early esophageal squamous cell carcinoma who underwent endoscopic resection and were registered in the multicenter cohort study to evaluate adequate surveillance for detection of second primary head and neck cancers. Gastrointestinal endoscopists examined the head and neck regions after 3-6 months of endoscopic resection for esophageal squamous cell carcinoma and subsequently every 6 months. An otolaryngologist also examined the head and neck regions at the time of endoscopic resection for esophageal squamous cell carcinoma and at 12 months intervals thereafter. RESULTS: During the median follow-up period of 49.4 months (1.3-81.2 months), 33 second primary head and neck cancers were newly detected in 20 patients (6%). The tumor site was as follows: 22 lesions in the hypopharynx, eight lesions in the oropharynx, two lesions in larynx and one lesion in the oral cavity. The 2-year cumulative incidence rate of second primary head and neck cancers was 3.7%. Among them, 17 patients with 29 lesions were treated by transoral surgery. One patient with two synchronous lesions was treated by radiotherapy. Two lesions in two patients were not detected after biopsy. All patients were cured with preserved laryngeal function. CONCLUSIONS: Surveillance by gastrointestinal endoscopy every 6 months and surveillance by an otolaryngologist every 12 months could detect second primary head and neck cancers at an early stage, thereby facilitating minimally invasive treatment.


Assuntos
Endoscopia , Neoplasias Esofágicas/cirurgia , Carcinoma de Células Escamosas do Esôfago/complicações , Carcinoma de Células Escamosas do Esôfago/cirurgia , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/etiologia , Segunda Neoplasia Primária/diagnóstico , Segunda Neoplasia Primária/etiologia , Idoso , Estudos de Coortes , Progressão da Doença , Endoscopia/efeitos adversos , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/patologia , Feminino , Neoplasias de Cabeça e Pescoço/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Qualidade de Vida
13.
Br J Radiol ; 93(1113): 20200323, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32584599

RESUMO

OBJECTIVE: Pulmonary hypertension (PH) is an underdiagnosed condition associated with poor survival and increased post-operative mortality in lung cancer. CT-based parameters of pulmonary artery enlargement are strong predictors of PH. We used these parameters to investigate pulmonary artery enlargement in lung and oesophageal cancer. METHODS: Consecutive patients with lung cancer (n = 100) or oesophageal cancer (n = 100) undergoing staging 18F-fluodeoxyglucose PET/CT were retrospectively identified. The transverse diameter of the main pulmonary artery (mPA) and ascending aorta, and the pulmonary artery-to-ascending aorta (PA:A) ratio were obtained. Abnormal values were defined following the Framingham Heart Study cohort. RESULTS: Lung cancer patients had a significantly increased mPA diameter compared to the oesophageal cancer patients (males: 27.29 ± 0.39 vs. 25.88 ± 0.24 mm, females: 26.10 ± 0.28 vs. 24.45 ± 0.18 mm). Similarly, a significantly increased proportion of these patients had an abnormal mPA diameter (males: 35.1% vs 12.5%, females: 32.6% vs 10.7%). Lung cancer patients also had a significantly higher PA:A ratio (males: 0.83 ± 0.01 vs. 0.79 ± 0.008, females: 0.85 ± 0.01 vs. 0.79 ± 0.009), with a larger proportion having an abnormal PA:A ratio (males: 24.6% vs 11.1%, females: 27.9% vs 14.3%). CONCLUSION: Simple measurements of mPA diameter and PA:A ratio reveal that lung cancer patients exhibit increased rates of pulmonary artery enlargement compared to oesophageal cancer patients. ADVANCES IN KNOWLEDGE: This study demonstrates there is an increased prevalence of pulmonary enlargement in lung cancer, easily detected on routine staging scans, holding implications for further work-up and risk stratification.


Assuntos
Neoplasias Esofágicas/complicações , Hipertensão Pulmonar/diagnóstico por imagem , Neoplasias Pulmonares/complicações , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Artéria Pulmonar/diagnóstico por imagem , Idoso , Aorta/diagnóstico por imagem , Neoplasias Esofágicas/diagnóstico por imagem , Feminino , Fluordesoxiglucose F18 , Humanos , Hipertensão Pulmonar/etiologia , Hipertrofia/diagnóstico por imagem , Hipertrofia/etiologia , Neoplasias Pulmonares/diagnóstico por imagem , Masculino , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Fatores Sexuais
14.
Medicine (Baltimore) ; 99(22): e20498, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32481466

RESUMO

To explore the outcome of placing a single Y-shaped tracheal self-expandable metallic stent (SEMS) to treat emergent carinal stenosis combined with stenosis of the right main and intermediate bronchi.The clinical and imaging data of 10 patients (8 males, 2 females) with carinal stenosis combined with stenosis of the right main and intermediate bronchi were retrospectively analyzed. There were 4 patients with esophageal cancer and 6 patients with lung cancer. All patients underwent treatment with a single Y-shaped tracheal SEMS. The long branch was inserted into the right main and intermediate bronchi, while the short branch was inserted into the left main bronchus. A modified Borg scale score was used as the criterion for assessing dyspnea in patients before and after stenting.A total of 10 Y-shaped tracheal SEMSs were successfully placed in 10 patients without any procedure-related complications. Compared with the score before stent placement, the mean Borg score for dyspnea after stent placement decreased from 7.6 to 0.8 (P = .04). Chest computed tomography showed that the stenosis disappeared 3 to 5 days poststenting. During the follow-up period, the most common complications were tumor ingrowth (n = 5) and granulation tissue hyperplasia (n = 7). The mean survival time after tracheal stent placement was 103 ±â€Š50 (23-172) days.The application of a single Y-shaped tracheal SEMS for emergent carinal stenosis combined with stenosis of the right main and intermediate bronchi can effectively relieve dyspnea through a simple operation.


Assuntos
Broncopatias/terapia , Stents Metálicos Autoexpansíveis , Estenose Traqueal/terapia , Idoso , Idoso de 80 Anos ou mais , Broncopatias/diagnóstico por imagem , Constrição Patológica , Neoplasias Esofágicas/complicações , Feminino , Humanos , Neoplasias Pulmonares/complicações , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Estenose Traqueal/diagnóstico por imagem
15.
Gan To Kagaku Ryoho ; 47(3): 469-471, 2020 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-32381918

RESUMO

We report the case of a patient with esophageal cancer accompanied by esophago-bronchial fistula and pneumonia, who experienced improved quality of life following multimodal therapy that included esophageal bypass surgery. A 56-year-old man was diagnosed with advanced esophageal cancer with an esophago-bronchial fistula on computed tomography scan. He underwent esophageal bypass surgery followed by definitive chemoradiotherapy. He started eating 12 days after the surgery and was discharged home after the completion of chemoradiotherapy. On follow-up, the primary lesion was found to be significantly decreased in size and the esophago-bronchial fistula was closed. Although the patient ultimately died owing to distant metastases, he enjoyed a prolonged period of survival following surgery. Multimodal therapy including esophageal bypass surgery is an useful strategy for treating patients with critical conditions such as esophago-bronchial fistula induced by esophageal cancer.


Assuntos
Fístula Brônquica , Fístula Esofágica , Neoplasias Esofágicas , Fístula Brônquica/etiologia , Fístula Esofágica/etiologia , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida
16.
Gan To Kagaku Ryoho ; 47(3): 487-489, 2020 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-32381924

RESUMO

BACKGROUND: Since the introduction of the guideline for the diagnosis and treatment of esophageal carcinoma in 2007, the indication for placing an esophageal stent has changed, especially with respect to the treatment of esophageal stricture after chemoradiotherapy(CRT). For CRT cases, irradiation after stent placement and stent placement after CRT are not recommended due to the risk of perforation. METHODS: Thirty-eight patients who underwent esophageal stenting in our department between January 2007 and December 2018 and who were diagnosed with thoracic esophageal cancer were included in this study. We retrospectively examined the safety and treatment effect of esophageal stent placement. RESULTS: Prior cancer therapy was observed in 16 cases(8 cases of chemotherapy and 8 cases of CRT). In the no prior therapy group, 13 cases were treated with BSC and 9 cases with chemotherapy. Esophageal stent placement after CRT was performed in 8 cases. Esophageal stent was placed 9(6-14)months after CRT. The stent patency period was 5(1-11)months, and the survival period after stent placement was 6(1-12)months. There was no difference in the frequency of complications and treatment outcomes of the CRT group compared with the non-CRT group. CONCLUSION: Cases undergoing esophageal stent placement after CRT can expect therapeutic effects similar to those of other cases. However, complications such as perforation can be fatal; thus, careful consideration should be given to each individual case for esophageal stent placement after CRT.


Assuntos
Neoplasias Esofágicas , Estenose Esofágica , Stents , Neoplasias Esofágicas/complicações , Estenose Esofágica/etiologia , Estenose Esofágica/cirurgia , Humanos , Estudos Retrospectivos
17.
Metas enferm ; 23(4): 69-78, mayo 2020.
Artigo em Espanhol | IBECS | ID: ibc-194584

RESUMO

OBJETIVO: el objetivo de este estudio ha sido localizar y sintetizar la información de las revisiones sistemáticas sobre el consumo de pipa de agua que han sido publicadas hasta el momento. MÉTODOS: en diciembre del año 2019 se llevó a cabo una revisión de la literatura mediante la búsqueda bibliográfica en las bases de datos PubMed/Medline, ISI Web of Science y Google Scholar que incluyó un total de 52 artículos. RESULTADOS: los efectos de este tipo de consumo más estudiados son los relacionados con ciertos tipos de cáncer, principalmente el de pulmón y esófago. Otros efectos incluyen alteraciones en las funciones pulmonares y cardiacas, así como afectaciones en la cavidad bucal. Entre los motivos referidos para fumar en pipa de agua están principalmente que no es perjudicial para la salud, una actitud positiva hacia su consumo, que no crea adicción y su aceptación social. También se considera este tipo de consumo como la puerta de entrada para otros tipos de consumo de tabaco. Se necesitan leyes específicas que regulen este tipo de consumo o la inclusión del mismo en las leyes generales que combaten el tabaco. CONCLUSIONES: esta es la primera revisión de revisiones sistemáticas que trata sobre el consumo de pipa de agua


OBJECTIVE: the objective of this study has been to locate and summarize the information from systematic reviews on waterpipe use that have been published so far. METHODS: a literature review was conducted on December 2019, through bibliographic search in the PubMed/Medline, ISI Web of Science and Google Scholar databases, including 52 articles in total. RESULTS: the most widely studied effects of this type of use are those associated with certain types of cancer, particularly lung and esophagus. Other effects include alterations in pulmonary and cardiac functions, as well as mouth cavity involvement. Some of the reasons reported for waterpipe use are mostly that it is not harmful for health, a positive attitude towards its use, that it is not addictive and is socially accepted. This use is also considered as the doorway to other types of use, or its inclusion within general laws against smoking. CONCLUSIONS: this is the first review of systematic reviews dealing with the use of waterpipes


Assuntos
Humanos , Fumar Cachimbo/epidemiologia , Fumar Cachimbo/prevenção & controle , Uso de Tabaco/epidemiologia , Neoplasias Pulmonares/complicações , Neoplasias Esofágicas/complicações , Boca/patologia , Fatores de Risco , Fumar Cachimbo/legislação & jurisprudência , Conhecimentos, Atitudes e Prática em Saúde
19.
J Cardiothorac Surg ; 15(1): 52, 2020 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-32228632

RESUMO

BACKGROUND: Esophageal squamous cell carcinoma with tumor thrombus in the arch of the azygos vein has not been reported to date. Neoadjuvant chemotherapy can decrease the stage in patients with advanced preoperative tumor staging, regaining surgical opportunities and significantly prolonging progression-free survival and overall survival. Herein, we present a case of esophageal squamous cell carcinoma accompanied by tumor thrombus in the arch of the azygos vein, and the patient underwent radical surgery after neoadjuvant chemotherapy. CASE PRESENTATION: A 63-year-old male with esophageal squamous cell carcinoma was found to have tumor thrombus formation in the arch of the azygos vein. Four courses of neoadjuvant chemotherapy with the TP regimen (paclitaxel plus nedaplatin) were given. Reexamination revealed a significant reduction in tumor and tumor thrombus volume. Therefore, McKeown radical resection for esophageal cancer and removal of the tumor thrombus in the arch of the azygos vein were performed. Postoperative pathology suggested complete remission of the esophageal tumor and the presence of small focal cancer tissues in the arch of the azygos vein. CONCLUSION: We report a case of esophageal squamous cell carcinoma with tumor thrombus formation in the azygos vein. We conducted radical resection after 4 rounds of neoadjuvant chemotherapy, and the pathological results revealed complete remission of the tumor. We report our experience addressing this rare case, and we hope to find the underlying mechanism of tumor thrombus formation and whether it has any effects on prognosis in our future study.


Assuntos
Veia Ázigos/cirurgia , Neoplasias Esofágicas/cirurgia , Carcinoma de Células Escamosas do Esôfago/cirurgia , Trombose/cirurgia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimioterapia Adjuvante , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/tratamento farmacológico , Carcinoma de Células Escamosas do Esôfago/complicações , Carcinoma de Células Escamosas do Esôfago/tratamento farmacológico , Esofagectomia , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estadiamento de Neoplasias , Compostos Organoplatínicos/administração & dosagem , Paclitaxel/administração & dosagem , Trombose/etiologia
20.
Ann Thorac Surg ; 110(2): 374-382, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32278754

RESUMO

BACKGROUND: Although both sarcopenia and systemic inflammation reportedly affect long-term outcomes of esophageal carcinoma (EC) patients, their reciprocal associations with survival outcomes have yet to be investigated. This study aimed to evaluate the survival impact of sarcopenia combined with the neutrophil-to-lymphocyte ratio (NLR) in EC patients undergoing esophagectomy. METHODS: In total, 378 EC patients were retrospectively reviewed. The cutoff value for NLR was set at the NLR median of the cohort. Sarcopenia was determined based on decreased skeletal muscle index calculated from computed tomography obtained before surgery. Univariate and multivariate Cox hazards models were applied to determine independent predictors of poor overall survival and cancer-specific survival. RESULTS: Sarcopenia was more common in the high-NLR group (2.57 or greater) than in the low-NLR group (less than 2.57; P = .01). In the high-NLR group, patients with sarcopenia had significantly poorer overall and cancer-specific survival than those without sarcopenia (P < .001). In contrast, there was no survival impact of sarcopenia in the low-NLR group. Patients with both high NLR and sarcopenia exhibited poor overall and cancer-specific survival (5-year overall survival = 44.4%, 5-year cancer-specific survival = 57.0%). Sarcopenia was independently associated with poor overall survival (hazard ratio = 1.95; P = .007) and poor cancer-specific survival (hazard ratio = 2.66; P = .002) as well as pathological stage III disease and noncurative resection in the high-NLR group. CONCLUSIONS: The survival and oncological impact of sarcopenia was noteworthy only when present with elevated NLR. The combination of 2 factors is rational for identifying EC patients likely to have poor survival outcomes.


Assuntos
Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/mortalidade , Inflamação/complicações , Sarcopenia/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Esofágicas/sangue , Neoplasias Esofágicas/cirurgia , Esofagectomia , Feminino , Humanos , Inflamação/sangue , Contagem de Leucócitos , Linfócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos , Estudos Retrospectivos , Sarcopenia/sangue , Taxa de Sobrevida
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