胃管状成形术在三切口食管癌切除术中的应用

目的探讨胃管状成形术在三切口食管癌切除术中的应用价值。方法对120例食管癌常规经颈胸腹三切口切除术中行胃管状成形术。结果术后声音嘶哑2例,谵妄2例,吻合口狭窄1例,无吻合口瘘、胸胃综合征及明显返流性食管炎等并发症,均顺利康复出院。结论经颈胸腹三切口食管癌切除术中行胃管状成形术,使胃扩张受限,可减轻胸胃潴留所致压迫症状及返流性食管炎;胸胃延长,张力减轻,使吻合区胃组织的供血相应增加,亦能减少吻合口瘘的发生。     

胃切除后食管癌手术方法选择

 目的　探讨胃大部切除或全胃切除后再患食管癌手术治疗术式。方法　回顾分析 1990年 1月至 2 0 0 1年 12月收治胃切除术后再患食管癌 2 9例资料。食管癌切除后的消化道重建方式 :残胃代食管术 2 0例、空肠代食管术 3例、结肠代食管术 6例。结果　 2 9例除 1例颈部食管结肠吻合口瘘、1例胸部食管残胃吻合口瘘、1例吻合口狭窄、3例肺部感染、其余均Ⅰ期愈合。结论　胃大部切除术后食管中下段癌采用残胃代食管术 ,食管中上段癌行结肠代食管术更为合理     

消化道吻合器颈部食管胃吻合治疗食管癌346例临床报告

目的探讨次全食管切除胃经食管床消化道吻合器颈部食管胃吻合治疗食管癌的手术效果。方法346例食管癌患者采用左后外侧六肋间切口,游离肿瘤并行次全食管切除,清扫肿大淋巴结。取左颈部胸锁乳突肌前缘切口,游离颈段食管,将胃经食管床主动脉弓后上置颈部,行食管胃消化道吻合器吻合。分析该手术及效果。结果术后残端癌4例,发生率为1.2%。吻合口瘘19例,发生率为5.5%。术后死亡1例,死亡率为O.6%。吻合口狭窄13例,发生率为3.8%,均经食管扩张治愈。结论该术式符合肿瘤彻底切除的原则,残端癌阳性率低。胃放置于食管床内对呼吸循环影响小。使用吻合器增加了吻合的可靠性,减少了术后并发症。即使发生了吻合口瘘,处理也相对简单,死亡率低。     

管状吻合器在食管癌颈部吻合中的应用

目的 探讨食管癌根治术中,食管胃颈部吻合中管状吻合器的应用方法。方法 回顾分析51例食管癌患者做食管癌根治术并用管状吻合器进行食管胃颈部吻合的结果。结果 术后吻合口瘘3例,无吻合口狭窄,无手术死亡和住院死亡。结论 管状吻合器颈部吻合术吻合完整快捷,明显地减少了手术操作时间和吻合口并发症的发生。     

全食管切除胃咽吻合治疗颈段食管癌和食管瘢痕狭窄8例报告

目的:探讨全食管切除胃咽吻合治疗颈段食管癌及全段食管狭窄的手术方法及效果.方法:全组共8例,其中7例为颈段食管鳞癌,TNM分期IIa期;1例为化学烧伤致全食管狭窄.采用左侧颈、胸径路切除食管,清除淋巴结,从小弯侧缩胃呈管状,与咽部行端侧吻合.结果:除1例术后7天发生吻合口瘘及肉芽肿,经引流、内镜微波治疗痊愈,其余7例无并发症发生,进食顺畅,术后平均18天治愈出院.随访6个月至5年,1例失访,存活5年、3年者各2例, 3例已超过6个月.结论:胃咽吻合治疗颈段食管癌及食管瘢痕狭窄,方法可行,并发症少,发生吻合口瘘容易控制.     

食管癌根治术后吻合口气管瘘的诊治与临床分析

目的:探讨食管癌根治术后食管胃吻合口气管瘘的诊治.方法:2003年6月-2013年10月我院共行食管癌根治术472例,对其中术后出现食管胃吻合口气管瘘并发症的病例进行回顾性分析.结果:食管胃吻合口气管瘘的发生率为1.27%(6/472),病死率为0.42%(2/472).6例患者中2例行手术治疗治愈;4例行保守治疗,2例治愈,2例死亡,结论:降低食管切除术后吻合口瘘的发生率及术中避免气管膜部损伤可预防食管胃吻合口气管瘘的发生.针对不同病情选择恰当的治疗方法能够提高食管胃吻合口气管瘘的治愈率.     

改良Ivor-Lewis术式在食管癌手术中的应用体会

目的　应用改良Ivor -Lewis术式治疗食管癌。方法　 1995年 2月至 1999年 9月我院对 86例食管癌病人应用右胸前外侧、上腹部正中切口切除胸段食管癌。同时采用机械方法经胸内进行食管、胃颈部吻合 (颈段食管胃吻合 )。结果　 86例中无手术死亡。无吻合口瘘、狭窄 ,无乳糜胸发生。 2例发生脓胸 ,经引流、抗感染治愈 ,1例病理检查切缘阳性 ,术后补充放疗。胃排空障碍 4例 ,经保守治愈。结论　改良Ivor-Lewis对食管中下段癌是较理想的术式。     

食管中段癌切除吻合口部位的选择

作者对１６４例食管中段癌作了切除术，其中颈部食管胃吻合术３９例，上下切缘无残留癌，发生吻合口瘘４例，均治愈，胸内食管胃弓上吻合１２５例，发生吻合口瘘６例死亡１例，上切缘残留癌１０例，作者对颈部和胸内两种部位吻合作了比较和分析，认为食管中段癌苇除颈部吻合利弊少，切除长度足够，无残留癌组织，即使发生了吻合口瘘，治疗也容易，大多能痊出院。     

胃管状成形加颈部吻合术在下段食管癌手术中的应用

目的探讨胃管状成形加颈部吻合术在下段食管癌手术中的应用价值。方法对144例下段食管癌患者分别予以胃管状成形加颈部吻合术(72例)、胃管状成形加胸腔内吻合术(72例)。结果全组无围手术期死亡发生。72例行胃管状成形加颈部吻合术食管癌患者术后吻合瘘4例,术后肺部感染5例,后期吻合口狭窄9例,轻度夜间返流4例,ARDS 2例;72例行胃管状成形加胸腔内吻合术患者术后吻合瘘14例,肺部感染7例,后期吻合口狭窄11例,轻度夜间返流5例,ARDS 3例。术后吻合口瘘的发生率2种术式比较差异有统计学意义(P<0.05)。结论应用胃管状成形加颈部吻合术使吻合瘘发生率及其危害降低,利于愈合,为下段食管癌的治疗提供了新的手术思路。     

食管癌贲门癌切除及食管(管状胃)胃侧侧吻合术

目的探讨食管癌、贲门癌切除、食管(管状胃)胃侧侧吻合术的治疗效果及应用前景。方法共有32例患者行此手术。贲门癌6例、食管癌26例;其中胸下段9例,胸中段12例,胸上段5例。术中按肿瘤手术切除原则常规游离食管及近端胃,切除肿瘤。行主动脉弓下吻合9例,经食管床主动脉弓上吻合10例,左胸左颈两切口4例,右胸顶吻合3例,右胸颈腹三切口6例。22例患者应用管状胃代食管,10例患者应用全胃代食管。行食管胃端端吻合+侧侧吻合术15例;食管胃端侧吻合+侧侧吻合术10例;胸下段食管癌患者行食管管状胃全侧侧吻合术7例。结果本组病例术后分期分别为Ⅱa期9例,Ⅱb期11例,Ⅲ期12例。全部病例手术顺利,术后未出现吻合口瘘,术后2周复查上消化道钡透及胃镜检查均见吻合口通畅、无狭窄,术后随诊0.5～2年不等,均未见吻合口狭窄。结论食管癌、贲门癌切除食管(管状胃)胃侧侧吻合术可降低吻合口并发症尤其是狭窄的发生,值得临床推广。     

Personalized Cancer Treatment for Ovarian Cancer

Recently there have been numerous advances in understanding the genetic basis of cancer which have resultedin more appropriate treatments. In this paper we describe the experience of the Burzynski Clinic, involved intreatment of numerous patients based on personalized approach using novel combinations for difficult-to-treatmalignancies, with gynecological cancers. This retrospective study was conducted by extracting data fromBurzynski Clinic’s medical records and comprehensive review. Among the advanced refractory ovarian cancerscases (N=33), an objective response (OR) was found in 42.4%. We anticipate that with improved technology andnovel therapeutics this rate will increase and adverse events will be reduced.     

Breast Cancer Classification to Select Patients for Cancer Treatment

Gene expression arrays have shown that breast cancer is comprised of at least four different molecular diseases. These are 1) basal-like breast cancer, 2) human epidermal growth factor receptor 2 (Her2)-positive/estrogen receptor (ER)-negative breast cancer; 3) luminal A breast cancer; and 4) luminal breast B cancer. Basal-like cancer is characterized by ER-negative, progesterone receptor–negative, and Her2-negative expressions. Luminal breast cancer is characterized by ER-positive expression, with the luminal B subtype exhibiting a higher expression of proliferation genes. Several studies have shown that luminal A breast cancer exhibits a better outcome compared with other classes. Also, recent studies have shown that the same subclass is less chemosensitive. These data suggest that some selected luminal A breast cancer cases could be spared adjuvant chemotherapy given their better outcome and lesser chemosensitivity compared with other subtypes of breast cancer. Although other subtypes are more chemosensitive, there is debate about whether some drugs could be active in specific subtypes. Anthracyclines have been reported to be more effective in Her2-overexpressing breast cancer, and cisplatin is currently under investigation in basal-like breast cancer. Finally, some data suggest that luminal B breast cancer exhibits higher sensitivity to aromatase inhibitors. Overall, molecular classes exhibit different sensitivity to conventional drugs. To what extent these data obtained in retrospective biomarker studies could be implemented in daily practice is a matter of debate given the heterogeneity of findings in different studies.     

Dendritic Cell Cancer Vaccines for Treatment of Colon Cancer

Despite advances in treatment modalities, colorectal cancer (CRC) still accounts for about half a million deaths yearly worldwide. The majority of metastatic CRC are unresectable, and of those who undergo resection, few are cured. Advances in chemotherapy and targeted therapy have improved survival, but options remain limited, making the case for incorporating novel modalities in CRC treatment paradigm. Our improved understanding of the tumor immune microenvironment had led to the development of novel immunotherapeutic agents that have been tested in clinical trials such as cancer vaccines. Cancer vaccines are designed to activate the effector immune cells in order to generate an immune response against tumors. Dendritic cell vaccines offer potential benefits for CRC patients but requires further evaluation. We reviewed the role of dendritic cells in the colorectal tumor microenvironment and dendritic cancer vaccine studies in colorectal cancer.     

National Cancer Act and Council for National Cancer Strategy

Based on the National Cancer Act, the Council for National Cancer Strategy was inaugurated and compiled the Basic Plans for National Cancer Strategy. Japan's cancer control will be promoted in accordance with the said laws hereafter. Japan's cancer control marked its 1st year and entered a very important phase. The next several years will be extremely important periods for Japan.     

胃癌的生物化疗

胃癌（Gastric carcinoma）具有明显的地域性，尤其是东亚三国（日本、韩国和中国）为高发区，约占全球总数的2／3，近年来发病率略呈下降趋势。可是在我国，胃癌仍高居各种恶性肿瘤之首。     

支气管成形术与肺癌

支气管成形术最大限度地保留了肺组织,使部分不能耐受全肺切除术的患者获得了手术机会,改善了部分患者术后的生活质量,且术后生存率亦不低于全肺切除术.     

Screening for Prostate Cancer

In the United States, prostate cancer will affect 1 man in 6 during his lifetime. Since the mid‐1980s, screening with the prostate–specific antigen (PSA) blood test has more than doubled the risk of a prostate cancer diagnosis. A decrease in prostate cancer death rates has been observed since that time, but the relative contribution of PSA testing as opposed to other factors, such as improved treatment, has been uncertain. The recent release of 2 large randomized trials suggests that if there is a benefit of screening, it is, at best, small. Methods to assess a man's risk of prostate cancer, including those tools that integrate multiple risk factors, are now available and should be used in risk assessment. Men undergoing screening for prostate cancer may reduce their risk of prostate cancer with finasteride. CA Cancer J Clin 2009;59:264‐273. © 2009 American Cancer Society, Inc.