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Zachariassen Salazar posted an update 6 months, 2 weeks ago
Forty-one patients in the SL group were compared with 22 patients in the RY group. Ryles tube removal (POD 8.2 versus 2.25, p less then 0.001), initiation of liquid diet (POD 8.43 versus 2.88, p less then 0.001), post-operative hospital stay (13.5 days versus 9.63, p less then 0.001), and interval between surgery and adjuvant treatment (37.75 days versus 28.88 days, p less then 0.002) were all in favor of the RY group. The delayed gastric emptying was also found to be significantly better in the Roux-en-Y surgery group (p less then 0.001). The Roux loop reconstruction following a stomach-preserving pancreaticoduodenectomy (SSPPD) is superior to single-loop reconstruction with respect to delayed gastric emptying. The lesser duration of hospital stay and early initiation of adjuvant therapy are an additional benefit of the Roux loop reconstruction.Postchemotherapy RPLND remains an integral part of management of testicular tumours. Nerve-sparing techniques can minimize the ejaculatory dysfunction due to the procedure. We report our functional and oncological outcomes for nerve-sparing RPLND in postchemotherapy settings. We analysed data from all patients undergoing nerve-sparing PC RPLND from January 1990 to December 2013 at our institute. Antegrade ejaculation and fertility issues were determined by patient history. Nerve sparing was achieved in 30% of patients undergoing PC RPLND. Of the 33 patients who underwent nerve-sparing PC RPLND, 19 (57.8%) had antegrade ejaculation. The mean time to antegrade ejaculation was 6.8 months. After a median follow-up of 75.61 months, 5-year disease-free survival was 98%. Nerve-sparing RPLND can improve functional outcomes without increasing recurrence rates in post chemotherapy setting.Advances in surgery and multidisciplinary approach have made limb salvage surgery feasible in most patients with tumours around the shoulder joint. Although resection and reconstruction options are complex, good outcomes can be achieved when performed at a specialised centre. The data of patients with bone tumours who underwent proximal humeral resection and reconstruction in a single cancer centre were prospectively analysed. Comparison between biological and non-biological reconstruction was done in seven patients of which three patients underwent biological reconstruction and four patients had non-biological reconstruction. Measurement data were presented as mean ± standard deviation. The mean values were compared using independent t test. Kaplan-Meier method was used to evaluate survival with log rank test for comparison among groups. A p value less than 0.05 was considered statistically significant at 95% confidence interval. There were six males and two female patients. Mean follow-up duration was 17.3 months. The mean age of patients was 24.7 ± 16.3 years. The mean functional score for biological reconstruction was 26.3 ± 1.16 and for non-biological reconstruction was 24.5 ± 1.3 with a p value of 0.1. Overall survival of patients with biological reconstruction was 75% and non-biological reconstruction was 100% with a p value of 0.3. Recurrence-free survival for biological reconstruction and non-biological reconstruction was 75% and 100%, respectively, with p value of 0.3. Limb salvage surgery in a dedicated cancer centre is a feasible option for most tumours around the shoulder joint. Biological and non-biological reconstructions both produced acceptable functional outcomes in our patients.This study aimed at reporting the surgical management of locally advanced thymoma (Masaoka stages III and IVA) and evaluating the factors predicting the survival. This is a retrospective analysis of patients operated for locally advanced thymoma from March 2012 to December 2019 in a thoracic surgery center in India. An analysis of all perioperative variables including complications was carried out. The influence of various predictors on survival was assessed by log-rank test. Out of total 54 patients, 42 (77.8%) had stage III and 12 (22.2%) had stage IVA. Upfront surgery was done in 34 (63%) patients, and induction chemotherapy was given in 20 (37%) patients. Pericardium was the commonest structure resected (79.6%) followed by the lung (51.8%), phrenic nerve (48.1%), major vascular structures (40.7%), parietal pleura (22.2%), diaphragm (9.2%), and right atrial appendage (1.8%). Forty-seven (87%) cases had complete (R0) resection, and the remaining 7 (12.9%) cases had incomplete (R1/R2) resection. There were no perioperative deaths ( 3″ structures resected with tumor were the poor prognostic factors for survival. An aggressive surgical approach, by an experienced team of cardiac and thoracic surgeons, aimed at complete resection is vitally important and can achieve excellent surgical and oncological outcomes even in locally advanced thymomas.For localized esophageal cancer, esophageal resection remains the prime form of treatment but is a highly invasive procedure associated with prohibitive morbidity. Minimally invasive esophagectomy (MIE) by laparoscopic or thoracoscopic approach was therefore introduced to reduce surgical trauma and its associated morbidity. Ziritaxestat solubility dmso We thereby review our minimally invasive esophagectomy results with short- and long-term outcomes. From January 2010 through December 2016, 459 patients with carcinoma esophagus and gastro-esophageal junction undergoing minimally invasive esophagectomy were retrospectively reviewed. The morbidity, mortality data with short- and long-term results of the procedure were studied. Patients were stratified into two arms based on the approach into minimally invasive transhiatal esophagectomy (MI-THE) and minimal invasive transthoracic esophagectomy TTE (MI-THE). Thirty days mortality in the whole cohort was 3.5% (2.5% in MI-THE vs. 5% in MI-TTE arm). Anastomotic leak rates (5 vs. 4.9%), median intensive care unit (ICU) stay (4 days), hospital stay (9 days), were similar between both the approaches. Major pulmonary complications were significantly higher in MI-TTE arm (18.9% vs 12.5%) (p 0.047). Cardiac, renal, conduit-related complication rates, vocal cord palsy, chyle leak, re-exploration, and late stricture rates were similar between the groups. The median number of nodes resected was higher in the MI-TTE arm (14 vs. 12) (p 0.002). R0 resection rate in the entire cohort was 89% (87.4% in MI-THE, 92% in MI-TTE arm p 0.12). The median overall survival and disease-free survival were also not different between MI-THE and MI-TTE arms (34 vs. 38 months, p 0.64) (24 vs. 36 months, p 0.67). Minimally invasive esophagectomy either by transhiatal or transthoracic approach is feasible and can be safely accomplished with a low morbidity and mortality and with satisfactory R0 resection rates, good nodal harvest, and acceptable long-term oncological outcomes.