Objective:This study aims to verify the feasibility and efficacy of laparoscopic lower mediastinal lymphadenectomy for Siewert typeⅡ/Ⅲadenocarcinoma of esophagogastric junction(AEG).Setting:An exploratory,observatio...Objective:This study aims to verify the feasibility and efficacy of laparoscopic lower mediastinal lymphadenectomy for Siewert typeⅡ/Ⅲadenocarcinoma of esophagogastric junction(AEG).Setting:An exploratory,observational,prospective,cohort study will be carried out under the Idea,Development,Exploration,Assessment and Long-term Follow-up(IDEAL)framework(stage 2 b).Paritcipants:The study will recruit 1,036 patients with cases of locally advanced AEG(Siewert typeⅡ/Ⅲ,clinical stage cT2-4 aN0-3 M0),and 518 will be assigned to either the laparoscopy group or the open group.Interventions:Patients will receive lower mediastinal lymphadenectomy along with either total or proximal gastrectomy.Primary and secondary outcome measures:The primary endpoint is the number of lower mediastinal lymph nodes retrieved,and the secondary endpoints are the surgical safety and prognosis,including intraoperative and postoperative lower-mediastinal-lymphadenectomy-related morbidity and mortality,rate of rehospitalization,R0 resection rate,3-year local recurrence rate,and 3-year overall survival.Conclusions:The study will provide data for the guidance and development of surgical treatment strategies for AEG.Trial registration number:The study has been registered in ClinicalTrials.gov(No.NCT04443478).展开更多
目的探讨新辅助化疗联合手术治疗Siewert Ⅱ、Ⅲ型局部进展期食管胃结合部腺癌(adenocarcinomas of the esophagogastric junction,AEGJ)的短期疗效。方法回顾性分析2013年1月至2015年6月在本院接受手术治疗的103例Siewert Ⅱ、Ⅲ型局...目的探讨新辅助化疗联合手术治疗Siewert Ⅱ、Ⅲ型局部进展期食管胃结合部腺癌(adenocarcinomas of the esophagogastric junction,AEGJ)的短期疗效。方法回顾性分析2013年1月至2015年6月在本院接受手术治疗的103例Siewert Ⅱ、Ⅲ型局部进展期AEGJ患者的临床资料,其中单纯手术者55例,新辅助化疗(Xelox方案)联合治疗者48例。结果单纯手术组与联合治疗组的手术时间[(182.73±38.27)min vs.(173.61±36.89)min,P>0.05]、术中出血量[(240.36±44.74)ml vs.(233.47±52.63)ml,P>0.05]及术后住院时间[(15.6±5.2)d vs.(14.2±5.6)d,P>0.05]比较差异无统计学意义;两组根治术后清扫所获淋巴结总数[(42.6±4.4)个vs.(40.7±3.3)个,P>0.05]差异无统计学意义,单纯手术组的转移淋巴结数多于联合治疗组[(12.4±2.6)个vs.(5.8±3.2)个,P<0.05];联合治疗组R_0切除率明显高于单纯手术组R_0切除率(83.33%vs.52.73%,P<0.05);术后并发症发生率联合治疗组与单纯手术组比较差异无统计学意义(20.83%vs.25.45%,P>0.05)。结论对SiewertⅡ、Ⅲ型局部进展期AEGJ患者实施新辅助化疗安全可行,可显著提高R0切除率,同时可减少淋巴结的转移率,并不增加其手术难度和术后并发症发生率。展开更多
Inflammatory fibroid polyp is one of the chronic inflammatory diseases in the digestive tract, which often mimics the submucosal tumor. Precise diagnosis is possible after removal of the detected lesion. Endoscopic re...Inflammatory fibroid polyp is one of the chronic inflammatory diseases in the digestive tract, which often mimics the submucosal tumor. Precise diagnosis is possible after removal of the detected lesion. Endoscopic removal is recommended as a safe and efficient method of the treatment. In this report the authors present a case of inflammatory fibroid polyp located in the cardia, which has been removed endoscopically. Twelve months later, recurrence of the lesion was noted and the patient was referred to surgical resection.展开更多
基金supported by the Chinese Medical Foundation(No.2020064)。
文摘Objective:This study aims to verify the feasibility and efficacy of laparoscopic lower mediastinal lymphadenectomy for Siewert typeⅡ/Ⅲadenocarcinoma of esophagogastric junction(AEG).Setting:An exploratory,observational,prospective,cohort study will be carried out under the Idea,Development,Exploration,Assessment and Long-term Follow-up(IDEAL)framework(stage 2 b).Paritcipants:The study will recruit 1,036 patients with cases of locally advanced AEG(Siewert typeⅡ/Ⅲ,clinical stage cT2-4 aN0-3 M0),and 518 will be assigned to either the laparoscopy group or the open group.Interventions:Patients will receive lower mediastinal lymphadenectomy along with either total or proximal gastrectomy.Primary and secondary outcome measures:The primary endpoint is the number of lower mediastinal lymph nodes retrieved,and the secondary endpoints are the surgical safety and prognosis,including intraoperative and postoperative lower-mediastinal-lymphadenectomy-related morbidity and mortality,rate of rehospitalization,R0 resection rate,3-year local recurrence rate,and 3-year overall survival.Conclusions:The study will provide data for the guidance and development of surgical treatment strategies for AEG.Trial registration number:The study has been registered in ClinicalTrials.gov(No.NCT04443478).
文摘目的探讨新辅助化疗联合手术治疗Siewert Ⅱ、Ⅲ型局部进展期食管胃结合部腺癌(adenocarcinomas of the esophagogastric junction,AEGJ)的短期疗效。方法回顾性分析2013年1月至2015年6月在本院接受手术治疗的103例Siewert Ⅱ、Ⅲ型局部进展期AEGJ患者的临床资料,其中单纯手术者55例,新辅助化疗(Xelox方案)联合治疗者48例。结果单纯手术组与联合治疗组的手术时间[(182.73±38.27)min vs.(173.61±36.89)min,P>0.05]、术中出血量[(240.36±44.74)ml vs.(233.47±52.63)ml,P>0.05]及术后住院时间[(15.6±5.2)d vs.(14.2±5.6)d,P>0.05]比较差异无统计学意义;两组根治术后清扫所获淋巴结总数[(42.6±4.4)个vs.(40.7±3.3)个,P>0.05]差异无统计学意义,单纯手术组的转移淋巴结数多于联合治疗组[(12.4±2.6)个vs.(5.8±3.2)个,P<0.05];联合治疗组R_0切除率明显高于单纯手术组R_0切除率(83.33%vs.52.73%,P<0.05);术后并发症发生率联合治疗组与单纯手术组比较差异无统计学意义(20.83%vs.25.45%,P>0.05)。结论对SiewertⅡ、Ⅲ型局部进展期AEGJ患者实施新辅助化疗安全可行,可显著提高R0切除率,同时可减少淋巴结的转移率,并不增加其手术难度和术后并发症发生率。
文摘Inflammatory fibroid polyp is one of the chronic inflammatory diseases in the digestive tract, which often mimics the submucosal tumor. Precise diagnosis is possible after removal of the detected lesion. Endoscopic removal is recommended as a safe and efficient method of the treatment. In this report the authors present a case of inflammatory fibroid polyp located in the cardia, which has been removed endoscopically. Twelve months later, recurrence of the lesion was noted and the patient was referred to surgical resection.
