Sealing the Breach: A Surgical Solution for Tracheoesophageal Fistula With a Simple Two-Layer Closure.

Tracheoesophageal puncture (TEP) followed by voice prosthesis placement stands as the primary method for voice rehabilitation after laryngectomy, heralded for its effectiveness. While generally well-tolerated, the procedure does pose potential long-term complications. These include prosthesis valve leakage, scarring, and prosthesis displacement, all of which can impede phonation capabilities. Of these, prosthesis leakage emerges as the most critical concern, precipitated by the progressive widening of the fistula. This complication can precipitate aspiration pneumonitis, stemming from the loss of physical separation between the esophagus and trachea. This case series details three instances where persistent tracheoesophageal fistula arose following TEP, necessitating surgical intervention. Herein, we present the clinical manifestations, surgical approach employing a simple two-layer closure, and ensuing outcomes.

Clinicopathological characteristics and postoperative prognosis of patients with nuclear pedigree of esophageal squamous cell carcinoma.

The aim of this work is to analyze the clinicopathological characteristics and prognostic factors of patients with nuclear pedigree of esophageal cancer. The clinicopathological data and follow-up information of 3,260 patients from different nuclear pedigree of esophageal cancer who underwent radical resection of esophageal cancer were collected, and the clinicopathological characteristics and prognostic factors of the patients were analyzed. The male to female ratio of 3,260 patients with esophageal cancer was 1.7:1. The diagnosis age was ranged from 32 to 85 (60.2 ± 8.1) years old. About 53.8% of the patients were ≥ 60 years old; About 88.8% of the patients came from the high incidence area of esophageal cancer; About 82.5% of the tumors were located in the middle and lower segments of esophagus; Poor, moderate and well differentiation accounted for 26.6%, 61.9% and 11.5% respectively; The surgical margin accounted for 94.3%; 47.6% of the tumors were shorter than 4 cm in length; Clinicopathological TNM stage (0+I) accounted for 15.2%, and stage II, III and IV accounted for 54.5%, 29.9% and 0.4%, respectively. Cox analysis showed that male, diagnosed age ≥ 60 years, tumor located in neck and upper esophageal segments, poor differentiation, tumor length ≥ 4 cm, and advanced TNM were independent risk factors for the prognosis of patients in nuclear pedigree with esophageal cancer. Gender, diagnosis age, tumor location, degree of differentiation, tumor length and TNM stage are the influencing factors for the prognosis of patients with nuclear pedigree of esophageal cancer, which will provide important data for the future study of esophageal cancer family aggregation.

[The effects of endoscopic sinus surgery on nasality and nasal patency].

OBJECTIVE: The purpose of this study was to describe the changes of resonance characteristics of the nasal cavity (including nasal sinuses) and nasal airway resistance (NAR) after endoscopic sinus surgery (ESS), through objective measurement of nasality and NAR before and after ESS. METHOD: Sixty- eight patients received the examinations of nasality and NAR using Nanometer and Atmos Rhinomanometry before and after ESS separately. RESULT: The nasality of patients with type III and type II stage 2, stage 3 chronic sinusitis was obviously improved ( P <0. 05), but still below the normal range 1 month after ESS. The nasality didn't recover to the normal level 3 months postoperatively. However the total NAR apparently decreased 1 months after ESS ( P <0. 01) and returned to normal 3 months postoperatively. Nasality and the total NAR of patients in type II stage 1 turned to normal 1 month after ESS. There are no distinctive changes in nasality and total NAR of type I stage 1 patients. CONCLUSION: The total NAR significantly decreased close to normal among the patients with severe sinus or/and nasal lesions after ESS, however nasality continued aberrant for a relatively long period. It is suggested that nasality can't be ameliorated immediately after ESS. On the contrary, it is possible to bring some undesirable effects to the professional voice users, such as announces, for the changed resonance characteristics of the nasal cavity due to the excessive destruction of its normal structure.