Radical Operation For Esophageal Carcinoma Research Articles

VS03.06: RADICAL OPERATION OF ESOPHAGEAL CANCER UNDER 3D THORACOSCOPE (ABDOMINAL PART)

Abstract Description To show the main operation procedure of the abdominal part of the radical operation of esophageal carcinoma. Disclosure All authors have declared no conflicts of interest.

Effect of all-in-one nursing intervention on the stress response and postoperative quality of life in patients following esophageal cancer surgery

Objective To investigate the effect of all-in-one nursing intervention on the stress response and postoperative quality of life in patients following esophageal cancer surgery .Methods From the October 2012 to March 2013 , 62 patients with radical operation of esophageal carcinoma were divided into all-in-one nursing intervention group （32 cases） and the routine nursing group （30 cases）.The blood samples of the two groups of patients were collected before operation （surgery day） （T0） and on the fifth day after operation （T1） to measure stress response indicators , including fasting blood glucose （ FBG ） , C-reactive protein （ CRP ） , interleukin -6 （IL-6）, plasma cortisol （Cor）.And using European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-30 （ QOL ） evaluated the early quality of life , before operation and the second week after opreation .Results The stress reaction index before operation had no significant difference between two group （P〉0.05）.On the fifth day after operation, the FBG, CRP and Cor levels of two groups were significantly higher than the preoperative level （t=3.724,7.203,4.137, respectively;P〈0.05）, but there was no significantly difference in the IL-6 level （t =0.452,P〉0.05）.The FBG, CRP, IL-6 and Cor levels of two groups on the fifth day after operation were significantly higher than the preoperative level （ t =3.031,5.361,2.864,3.534,6.990,10.755,2.415,8.166, respectively;P〈0.05）.Scores of each function item and symptom before operation had no significant difference between the two groups （P〉0.05）.And two weeks after the operation , the functions of the research group were higher than those in the control group （ P〈0.05 ） .Symptoms scores of study group was lower than those in the control group , and there were statistically significant differences in seven aspects （ P〈0.05）, but the other two aspects had no significant differences （P〉0.05）.Conclusions All-in-one nursing intervention can significantly reduce stress reaction and improve the quality of life in postoperative patients with esophageal cancer . Key words: Esophageal tumour; Stress response; Quality of life; All-in-one nursing

Effects of early enteral nutrition on short-term quality of life in patients with esophageal carcinoma after operation

A total of 62 patients with radical operation of esophageal carcinoma were divided into all-in-one nursing intervention group (research, n=32) and routine nursing group (control, n=30). With regards to postoperative flatus time, removal of chest tube drainage time, postoperative hospital stay and hospital costs, the research group was lower than the control group (P<0.05). After 2 weeks, from the postoperative quality of life questionnaire with the European Organization for Research and Treatment of Cancer, the scores of overall health of enteral nutrition group were higher than those of parenteral nutrition group while the symptom scores of fatigue, nausea & vomiting, insomnia, decreased appetite, constipation and economic difficulties were less than parenteral nutrition group (P<0.05). Early postoperative enteral nutrition can improve the quality of life in patients with esophageal cancer. Key words: Esophageal neoplasms; Quality of life

Two Cases of Early Carcinoma of a Reconstructed Gastric Tube after Esophagectomy Treated Extendedly with Endoscopic Submucosal Dissection

.Yamaguchi Med J (Yamaguchi Igaku)53:103-107,2004 33) Motoyama S,Mori K,Maruyama K,Sato Y,Hayashi K,Usami S,Suzuki H,Ogawa J:S-1 chemotherapy for cancer of the gastric tube used for esophageal reconstruction following surgery for esophageal cancer(in Japanese with English abstract).Jpn J Cancer Chemother (Gan to Kagaku Ryoho)34:2287-2290,2007 34) Yamasawa K,Shimizu T,Shimosato A,Mihara F,Tokuhara M,Hashimoto M,Saito Y,Endo H,Tamegai Y: Two cases of cancer in the reconstructed gastric tube after resection of esophageal cancer-an analysis of 7 cases in our hospital-(in Japanese with English abstract).Jpn J Gastroenterol(Nippon Shokakibyo Gakkai Zasshi)106: 793-799,2009 35) Koyanagi K,Kanai T,Nakagawa M,Nagase T,Tawara H,Tabuchi S,Koyama I:Endoscopic treatment for metachronous early gastric carcinoma in a reconstructed gastric tube after radical operation of esophageal carcinoma -summary of 29 reported cases-(in Japanese).Prog Dig Endosc 74:24-27,2009 36) Suzumura K,Oh K,Iimuro Y,Yamanaka J,Kuroda N,Hirano T,Okada T,Uyama N,Satake M,Fujimoto J:A case of gastric tube cancer 4 years after esophagectomy for thoracic esophageal cancer treated by endoscopic mucosal resection (in Japanese with English abstract).JJSC (Nihon Gekakei Rengo Gakkaishi)34:582-586,2009 (2010.10.21received;2010.12.13accepted) 88 Shinshu Med J Vol.59 Koide.Suzuki.Akamatsu et al.

The effect of the synthesized respiratory training on the patient's lung function who receives three-field radical operation of esophageal carcinoma

Objective To evaluate the results of synthesized respiratory training before operation on lung function. Methods Seventy cases of patients who received three -field radical operation of esophageal carcinoma, were doing respiratory training during the period from the day of admission to the day before the operation, in order to observe the changes of lung function. Results After the training, the vital capacity (VC) , forced vital capacity (FVC) , inspiratory capacity (IC) and maximal ventilatory volume (MVV) had been obviously improved (P < 0. 01 ) . Conclusions The synthesized respiratory training can improve the patients'lung function and the tolerance of three - field radical operation of esophageal carcinoma. Key words: Synthesized respiratory training; Lung function; Three-field radical operation

Effects of patient-controlled analgesia with small dose ketamine combined with morphine and the influence thereof on plasma beta-endorphin level in patients after radical operation for esophageal carcinoma

To evaluate the effects of patient-controlled analgesia (PCA) with small dose ketamine combined with morphine on analgesia and influence thereof on the plasma beta-endorphin (EP) level in the patients after radical operation for esophageal carcinoma. Thirty ASAI-II patients, aged 35-65, weighing 42-75 kg, with visual analogue score>or=3, undergoing elective radical operation for esophageal carcinoma under general anesthesia received intravenous morphine 2 - 3 mg were randomly divided into 2 equal groups: group m receiving morphine 0.02 mg.kg(-1).h(-1), and with group mk receiving morphine 0.02 mg.kg(-1).h(-1) combined with ketamine 0.08 mg.kg(-1).h(-1) for 50 h. In the course of treatment the patients received intravenous injection of morphine 2-3 mg when the VAS was >or=3. VAS was recorded 4, 8, 20, 24, and 48 h after operation. The amount of morphine used after operation, PCA button pressing times (effective/active), side effects, and vital signs including pulse, saturation of blood oxygen, respiratory rate, heart rate, and average arterial pressure were recorded. Central venous blood samples were collected when entering the operation room (T0), by the end of operation (T1), and 6 h (T2), 24 h (T3), and 48 h (T4) after operation respectively to examine the beta-endorphin level. During the period 4-48 h after operation the VAS scores of the group mk were significantly lower than those of the group m in activity state (all P<0.05) and were not significantly different those of the group m at resting state (all P>0.05). The total amount of morphine consumed and the actual PCA button pressing times were significantly less in the group mk than in the group m (both P<0.05). The incidence rates of nausea, vomiting, and pruritus of the group mk were all significantly lower than those of the group m (all P<0.05). There were not significant differences in the incidence rates of dreaming and pseudoesthesia between these 2 groups. All the vital signs were stable in the 2 groups. The plasma beta-EP levels at the time point T1 of these 2 groups were both significantly higher than those at T0 (both P<0.05). The plasma beta-endorphin levels at T2-4 of the group mk decreased gradually from the level at T1 to the level at T0, and the plasma beta-endorphin levels of the group m rapidly decreased from the level at T0 to the T0 level and remained at this level to the 48 h after operation. The combination of small dose of ketamine with morphine provides optimal analgesia with low side-effect rate and little effect on the plasma beta-EP level.

Endoscopic Treatment for Metachronous Early Gastric Carcinoma in a Reconstructed Gastric Tube after Radical Operation of Esophageal Carcinoma -Summary of 29 Reported Cases-

食道癌手術成績の向上に伴い再建胃管の異時性胃癌症例は増加しており，今後，早期胃管癌に対する内視鏡的診断および治療はさらに重要になるものと考えられる。そこで早期胃管癌の内視鏡的治療報告例29例をまとめ，その臨床病理学的特徴を検討した。発見動機はほとんどが術後の定期的内視鏡検査（23例，79％）で，胃管癌発見までの期間は18～221カ月（中央値54カ月）であった。病変占居部位は幽門側に多く，高分化型腺癌の頻度が高く，肉眼型は隆起型が多いなどの特徴を認めた。内視鏡的粘膜切除術が25例（86％）に施行されていたが，一括切除例は6例であった。手術侵襲を考慮した適応拡大とともに胃管作成に伴う形態変化や瘢痕なども一括切除を困難にしている原因と考えられた。内視鏡的粘膜切除術後の再発例の報告は自験例以外にないが，自験例は再発部位にアルゴンプラズマ凝固法を施行し局所コントロールに有効であった。 食道癌術後の早期胃管癌発見を目的とした定期的上部消化管内視鏡検査は重要であり，胃管癌の発見期間を考慮すると食道癌術後5年以上経過例にも必要であると考えられた。また，早期胃管癌に対する内視鏡的治療は安全性も高く低侵襲であり，積極的に施行しうると考えられた。

Evaluation of tracheal mucosal blood flow during an extended radical operation for esophageal carcinoma: clinical and experimental studies.

Using the hydrogen gas clearance method, a plate-type probe was attached to the surface of the cuff of an endotracheal tube in order to measure the ischemic changes in the tracheal mucosa produced by peritracheal lymph node dissection. In eight human subjects with intrathoracic esophageal carcinoma, the tracheal mucosal blood flow was 40.1 ml/100 g per minute after they had undergone a right thoracotomy and then decreased to 13.0 ml/100 g per minute after they had further received an extended radical operation preserving the right bronchial artery. No tracheal ulcers were seen. The same ischemic changes in the tracheal mucosa were also measured in dogs. The right bronchial artery contributes about one-third of the total blood flow to the trachea and this was thus calculated to be about 10-14 ml/100 g per minute.

Five year survivors after radical operation for esophageal carcinoma: Influence of pathological findings

Five year survivors after radical operation for esophageal carcinoma: Influence of pathological findings