Objective. To compare the clinical efficacies of mediastinoscope-assisted and thoracoscope-assisted esophagectomy. Materials and Methods. Seventy-six patients with esophageal cancer who underwent minimally invasive esophagectomy at the General Hospital of Ningxia Medical University between June 2015 and January 2019 were retrospectively evaluated. Among them, 28 patients underwent mediastinoscope-assisted transhiatal esophagectomy (MATHE), and 48 received thoracoscope-assisted transthoracic esophagectomy (TATTE). The perioperative clinical data and follow-up data of the 2 groups were compared. Results. All operations were successful in both groups. MATHE was favorable in terms of operation time, intraoperative blood loss, drainage volume 3 days after surgery, postoperative hospital stay, and hypoproteinemia ( P < .05). Lymph node dissections were less than those in the TATTE ( P < .05). No significant differences in long-term postoperative complications and survival rate were found between the 2 groups ( P > .05). Conclusion. MATHE has the advantages of minimal trauma, shorter operation time, less intraoperative blood loss, and faster recovery. More adequate tumor clearance in terms of lymph node dissection can be achieved with TATTE. However, the comparison of survival rates between the 2 groups is similar.
Background: To study the application value of standard uptake value (SUVmax), a positron emission tomography/computed tomography (PET/CT) index in the diagnosis and evaluation of the prognosis of patients with gastric cancer who have not received any treatment. Methods: A retrospective analysis was made on the patients who were diagnosed to have gastric cancer at the General Hospital of Ningxia Medical University and received a PET/CT examination prior to treatment. According to different factors like sex, pathological stage, and survival time, the SUVmax in the results of 18F-labelled fluoro-2-deoxyglucose (18F-FDG) PET/CT examination was statistically compared and analysed. Results: A total of 110 newly diagnosed patients with gastric cancer were included in this study. Pathological results confirmed that there were 78 cases of gastric adenocarcinoma, 30 cases of primary gastric lymphoma and two cases of chronic atrophic gastritis. The difference between the primary gastric lymphoma group and gastric adenocarcinoma groups was statistically significant (t = 4.13, P < 0.05). In the postoperative pathological report of patients with gastric cancer, the SUVmax of stage I, stage II, stage III and stage IV were 2.89 ± 1.36, 14.09 ± 9.32, 7.36 ± 3.72, and 10.20 ± 1.91, respectively, the difference between each group was statistically significant (F = 16.10, P < 0.05).The univariate survival analysis showed that there was a significant difference in survival time between the low SUVmax and high SUVmax groups (X2 = 5.08, P < 0.05). Cox multivariate survival analysis showed that SUVmax was an independent factor affecting postoperative survival time of patients with gastric adenocarcinoma (P < 0.05). Compared with the low SUVmax group, patients in the high SUVmax group had a higher postoperative death risk than those in the low SUVmax group, hazard ration (HR) = 3.91 (95% confidence interval [CI]: 1.09-14.01). Conclusion: The index of SUVmax in PET/CT can provide a reliable semi-quantitative diagnostic value for pathological staging after gastric cancer surgery. Furthermore, SUVmax has an important reference value for the survival time of patients after gastric cancer surgery, which can better guide clinical treatment.
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