ABSTRACT
Active exploration for building a model of medical alliances fitting local needs, proves imperative for the functional positioning of medical institutions, promoting inter-institutional cooperation and enhancing the capacity of primary medical services. The authors described experiences and insights of the No.1 Affiliated Hospital and the People′s government of Quangang District in their partnership, and building a brand new model of medical alliance between a hospital and a local government. Also presented are characteristics of such a model, and analysis of operational data in benefiting the people. They held that such a partnership is a worthy attempt in the healthcare reform, by means of building medical alliances between local government and provincial hospitals. Such a practice can provide valuable references for promoting government-hospital synergy, elevating primary healthcare capacity and advancing the hierarchical medical system.
ABSTRACT
Objective: To explore the security and the radical and clinical value of thoracoscopic-laparoscopic esophagectomy with two-field lymph node dissection for middle esophageal cancer through comparison with open esophagectomy. Methods: A total of 410 stage II to stage III esophageal cancer patients who underwent two-field lymph node dissection with two different methods (thora-colaparoscopic esophagectomy and open esophagectomy) from January 2009 to July 2013 in Uninon Hospital, Fujian Medical Universi-ty, were analyzed retrospectively. General pathological parameters, operative procedures, and short-term outcomes were collected and compared between the two groups (TLG and OG). Results: No significant differences were found regarding general pathological pa-rameters, such as gender, age, etc. Significant differences between thoracolaparoscopic and open two-field lymph node dissection esoph-agectomy were observed in terms of esophagectomy intraoperative blood loss [(206 ± 138) mL vs. (240±111) mL] and the mean num-ber of dissected lymph node per person [(26.6±8.6)/per vs. (21.7±9.2)/per]. Overall postoperative morbidity rate in OG was 35.2%, and its difference from that of TEG (25.8%) is statistically significant (P<0.05). Regarding single complications, such as pulmonary infec-tion and arrhythmia, OG showed evidently superior results (P<0.05). Meanwhile, anastomotic stricture and hoarseness rate are higher in TEG (P<0.05), and the difference was statistically significant as well. Conclusion: Thoracolaparoscopic two-field esophagectomy is technically feasible and safe and can achieve radical tumor resection.