Clinical features and management of pyothorax due to postoperative cervical anastomotic leakage in esophageal cancer surgery / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics and managements of pyothorax due to postoperative cervical anastomotic leakage after esophageal cancer surgery.</p><p><b>METHODS</b>From January 2006 to January 2013, 3342 patients with esophageal carcinoma underwent esophagectomy and cervical esophagogastric anastomosis. Of them, 19 patients developed pyothorax following cervical anastomotic leakage and their clinicopathological data were analyzed retrospectively.</p><p><b>RESULTS</b>All the patients underwent a cervical anastomosis via a three-incisional approach (right cervicothoracic mid-abdominal incision, RT group, n=1094) or a two-incisional approach (left cervicothoracic incision, LT group, n=2248). The total number of cervical anastomotic leakage cases was 237, of which 152 cases were in LT group (6.8%), and 85 cases in RT group (7.8%), respectively (P=0.287). The incidence of pyothorax was 2.0% (n=3) in LT group, and 18.8% (n=16) in RT group, respectively (P<0.01). Fourteen cases develop pyothorax within 3 days after operation. The main symptoms were high fever, dyspnea and chest pain. All the pyothorax patients received conservative treatments, including thoracic closed drainage, nasogastric tube placement, jejunal stoma, nutritional support, antibiotics and symptomatic treatment. Sixteen cases were cured, while 3 cases were dead.</p><p><b>CONCLUSIONS</b>The right thoracotomy approach predisposes the cervical anastomotic leakage-associated pyothorax. Sufficient drainage and sufficient nutritional support are critical to the treatment.</p>

Gene expression profiling study of HPV-16 positive and HPV-negative esophageal squamous cell carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the difference in gene expression between human papillomavirus (HPV)16-positive and HPV-negative esophageal squamous cell carcinoma(ESCC) .</p><p><b>METHODS</b>Eight HPV 16-positive and seven HPV-negative ESCC specimens were evaluated by PCR. The samples were then determined for gene expression profiling using Solexa Sequencing Chip followed by bioinformatics analysis.</p><p><b>RESULTS</b>A total of 796 differentially expressed genes between HPV 16-positive and HPV-negative ESCC were observed. Among them, 366 were up-regulated while 430 were down-regulated. Functional classification and pathway analysis showed that the functions of these genes were mostly related to tumor morphology, immune, and inflammatory response, cellular growth and proliferation and cellular movement. Of these, factors related to immune and inflammation were the most representative.</p><p><b>CONCLUSION</b>Differences in immunologic factors may be associated with HPV infection in esophageal cancer.</p>