Risk factors analysis of atrial fibrillation after radical esophagectomy / 中国胸心血管外科临床杂志

@#Objective     To analyze the risk factors of atrial fibrillation (AF) after radical esophagectomy, providing the basis for prevention and treatment of AF after radical esophagectomy. Methods     We conducted a retrospective analysis of 335 patients' clinical data, who accepted laparoscopic combined thoracic or open radical esophagectomy in the same treatment group at Department of Thoracic Surgery of Shengjing Hospital of China Medical University between January 2014 and August 2016. There were 262 males and 73 females at age of 65.1 (43-78) years. Results     There were 48 of 335 patients with AF within 1 week after surgery. By univariate analysis: age, gender, history of peripheral vascular disease and cardiac stents or angina pectoris, preoperative brain natriuretic peptide (BNP), preoperative left ventricular diastolic dysfunction, operation pattern, intraoperative blood transfusion and lymph nodes and pericardial adhesion were possible risk factors. By multivariate analysis: age, gender, history of cardiac stents or angina pectoris, preoperative BNP, operation pattern, intraoperative blood transfusion and lymph nodes and pericardial adhesion were risk factors. Conclusion     The risk factors of AF after radical esophagectomy are age, gender, history of cardiac stents or angina pectoris, preoperative BNP, operation pattern, intraoperative blood transfusion and lymph nodes and pericardial adhesion. Perioperative positive intervention to above factors may reduce the incidence of postoperative AF.

The risk factors analysis of complications of 364 cases in treatment of radical esophagectomy / 临床外科杂志

Objective To study the risk factors of complications of 364 cases in treatment of rad-ical esophagectomy.Methods 364 patients underwent two or three-incision radical esophagectomy and the clinic data were retrospectively analyzed.After review of the reference,ten factors were regarded as the potential risk factors of postoperative complications,then univariate and multivariate analyses were per-formed.Results In 364 patients,66 patients had complications of this research field within postoperative 6 months.By univariate analysis,preoperative nutritional risk score、T-staging、preoperative complications、operation time、operation experience、anastomotic position、anastomotic extra manual suturing were deter-mined as influence factors.By multivariate analysis,preoperative nutritional risk score≥3、T-staging score≥3、preoperative complications、operation time≥240 min、cervical anastomosis were determined as risk factors,anastomotic extra manual suturing was determined as a protective factor.Conclusion The risk factors of the complications after radical esophagectomy are preoperative nutritional risk score≥3、T-stag-ing score≥3、preoperative complications、operation time≥240 min、cervical anastomosis;and the protective factor is anastomotic extra manual suturing.Paying attention and controling these risk factors may reduce the occurrence of postoperative complications.

Patterns of Lymph Node Recurrence after Radical Surgery Impacting on Survival of Patients with pT1-3N0M0 Thoracic Esophageal Squamous Cell Carcinoma

The aim of this study was to investigate how patterns of lymph nodes recurrence after radical surgery impact on survival of patients with pT1-3N0M0 thoracic esophageal squamous cell carcinoma. One hundred eighty consecutive patients with thoracic esophageal squamous cell carcinoma underwent radical surgery, and the tumors were staged as pT1-3N0M0 by postoperative pathology. Lymph nodes recurrence was detected with computed tomography 3-120 months after the treatment. The patterns of lymph nodes recurrence including stations, fields and locations of recurrent lymph nodes, and impacts on patterns of survival were statistically analyzed. There was a decreasing trend of overall survival with increasing stations or fields of postoperative lymph nodes involved (all P<0.05). Univariate analysis showed that stations or fields of lymph nodes recurrence, and abdominal or cervical lymph nodes involved were prognostic factors for survival (all P<0.05). Cox analyses revealed that the field was an independent factor (P<0.05, odds ratio=2.73). Lymph nodes involved occurred predominantly in cervix and upper mediastinum (P<0.05). In conclusion, patterns of lymph node recurrence especially the fields of lymph nodes involved are significant prognostic factors for survival of patients with pT1-3N0M0 thoracic esophageal squamous cell carcinoma.

Research in correlation between quality of life and symptom distress of esophageal cancer patients undergoing postoperative chemotherapy / 中国实用护理杂志

Objective To describe the quality of life and symptom distress in esophageal cancer patients undergoing postoperative adjuvant chemotherapy,and explore the influence of symptom distress on quality of life.Methods The Functional Assessment of Cancer Therapy-General (FACT-G),M.D.Anderson Symptom Inventory (MDASI) and demographic questionnaire were used to measure eighty-four patients undergoing postoperative adjuvant chemotherapy.Results The total average score of quality of life in patients undergoing chemotherapy after radical esophagectomy was (65.95±13.76) points.There was a significanfly negative relationship between the symptom distress and the severity of symptom and quality of life.Analysis of multiple factors showed that education level and symptom distress were the included variables in the multiple regression equation of quality of life,and the R2 was 0.253.Conclusions Quality of life in esophageal cancer patients undergoing postoperative adjuvant chemotherapy is influenced by many factors.The nurses should take measures to manage the symptom of patients and improve the quality of life of the patients.

Effect of different external nasogastric tube fixations on unplanned nasogastric tube removal after radical esophagectomy for esophageal cancer / 现代临床护理

Objective To investigate the effects of three external nasogastric tube fixations on unplanned nasogastric tube removal after radical esophagectomy for esophageal cancer.Methods Two hundred and thirty four esophageal cancer patients who underwent radical esophagectomy with nasogastric intubation were assigned into conventional group I(n=74),conventional group II (n=79)and experiment group(n=81)using random number table.For external fixation of the nasogastric tube,the traditional group I used“3M”silk tape,the traditional group II used a white flat strap with two knots and the experiment group used anI-shaped nasal fixation tape combined with a flapping cheek fixation tape.The three groups were compared in terms of displacement of the indwelling nasogastric tube and slippage of the tube.Results The displacement rate of nasogastric tube and the rate of slippage in the experiment group were both significantly lower than those in both conventional groups I and II(all P<0.05).Conclusion TheI-shaped nasal fixation tape combined with a flapping cheek fixation tape in fixing the nasogastric tube can effectively reduce the incidence of unplanned removal of nasogastric tube and meanwhile the patients may feel comfort and satisfactory.