RESUMEN
<p><b>OBJECTIVE</b>To explore the surgical treatment of hypopharyngeal and cervical esophageal cancers and the ways of reconstruction after hypopharyngo-oesphagectomy, and to evaluate their efficacy.</p><p><b>METHODS</b>Twenty five patients with cancer of the laryngopharynx and cervical esophagus treated in our department between 1995 and 2007 were included in this study. Their clinical data were restrspectively analyzed. Among them, 17 cases had the tumor originated from the pyriform sinus, 3 of the posterior pharyngeal wall and 5 of the postcricoid region. Acording to the 2002 UICC criteria, all the tumors were stage T4, including 9 patients with cN0, 11 with cN1, and 5 with cN2 disease. The pharyngoesophageal defect reconstruction methods were as following: pharyngogastric anastomosis in 7 patients, free jejunal transplantion in 4, laryngotracheal flap in 8, and pectoralis major musculocutaneous flap in 6 patients. All patients were treated with modified and/or selective neck dissection. Among them, 8 cases received pre-operation radiotherapy, 17 received post-operative auxiliary radiotherapy.</p><p><b>RESULTS</b>There was no operation death case in this group. All patients were followed up for 3 to 5 years. Three patients died in the first year. According to Kaplan-Meier analysis, the 1-year survival rate was 88.0%, 3-year survival rate was 48.0%, and 5-year survival rate was 28.0%.</p><p><b>CONCLUSIONS</b>The use of primary repair of the defects of laryngopharynx and cervical esophagus expands the operative indication for cancers of the laryngopharynx and cervical esophagus, improves the survival rate and life quality of the patients. Regarding the repair method of choice, site of the tumor and size of the defect are the most important factors regarding choice of reconstruction method, while the patients' age and general condiction should also be considered to minimize the complications as more as possible.</p>
Asunto(s)
Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Carcinoma de Células Escamosas , Patología , Radioterapia , Cirugía General , Esofagectomía , Métodos , Estudios de Seguimiento , Neoplasias Hipofaríngeas , Patología , Radioterapia , Cirugía General , Hipofaringe , Cirugía General , Estimación de Kaplan-Meier , Neoplasias Pulmonares , Escisión del Ganglio Linfático , Metástasis Linfática , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Faringectomía , Métodos , Procedimientos de Cirugía Plástica , Métodos , Estudios Retrospectivos , Tasa de SupervivenciaRESUMEN
Objective To analyze the antimicrobial susceptibility of Mycoplasma isolates for rational antimicrobial therapy. Methods BioM?rieux IST kit was used for identification and susceptibility testing of Mycoplasma strains.Results Mycoplasma was positive in 49.5% of the specimens tested.Of the Mycoplasma detected,Ureaplasma urealyticum(Uu)alone accounted for 74.7%,Mycoplasma huminis(Mh)alone accounted for 18.1%,and Uu+Mh was identified in 7.2% of the patients.The results of antimicrobial susceptibility testing showed that the Mycoplasma isolates were most susceptible to doxycycline (98.1%).Ciprofloxacin was the least active (17.3%).Conclusions Doxyeycline,josamycin,and clarithromycin can be used in the treatment of urinary tract infections caused by Mycoplasma.