TIVAPs provide safe and reliable vascular access for patients on chemotherapy but require utmost care by a dedicated team of trained medical professionals and paramedics experienced with the use of such ports, in order to minimize the complications and their continued use while administering treatment.

Sentinel lymph node biopsy shows promise as a minimally invasive technique that samples the first echelon (station) of nodes to predict the need for more extensive neck dissection. This paper discusses the accuracy and feasibility of sentinel node and "station II node" biopsy for predicting the status of neck in 20 patients of oral cancer. We identified sentinel node in these patients. The next higher-order nodes, that is, second echelon of nodes known as "station II nodes" were delineated by further injecting 0.1 ml of isosulfan blue dye in sentinel lymph node. Identification rate for station I nodes was 95 %. Station II nodes were identified in 84 % of patients. One patient had false negative station I node. Station II node status was false negative in two patients. "Station I and station II concept" is feasible in early-stage tumors of oral cavity.

Objective: To evaluate the accuracy of CT in the diagnosis of esophageal fistula (Anastomotic leakage). Methods: Retrospective analysis of 186 cases of suspected postoperative esophageal postoperative intracavitary AL patients, 70 cases take oral 60% compound diatrizoate (contrast agent) CT examination and 116 cases take oral contrast agent CT examination. The CT images of oral or non-oral contrast agents were observed by two imaging physicians (Physician 1 and Physician 2, respectively). Kappa test was used to evaluate the consistency of two physicians in diagnosing AL. The variables related to AL were screened by regression analysis was used to confirm the reliable signs of AL. Results AL49 cases, no AL137 cases. The diagnostic sensitivity and specificity of AL were 79.6%, 83.7%, 83.9% and 84.7% respectively. The positive predictive value was significantly improved by oral contrast (from 40.6% to 89.7%, from 39.4% to 96.5%, P <0.05). The sensitivity and specificity were 83.3%, 86.7%, 97.5% and 97.5% respectively. There was also a high correlation between the accumulation of gas and anastomotic effusion. The univariate analysis showed that all of them were related to AL (P <0.05). Multivariate analysis showed independent correlation of contrast agent spillover. Conclusion CT can be a comprehensive assessment of postoperative esophageal AL-related signs, CT combined with oral contrast agent can improve the diagnostic accuracy and the contrast agent spillover is the most reliable signs.

BACKGROUND: In many patients with early breast cancer, the sentinel lymph node (SLN) is the sole site of regional nodal metastasis. This subgroup of patients may not benefit from completion axillary lymph node dissection (CALND). AIMS:This pilot study evaluates the status of 2 nd echelon (station) lymph nodes in the axilla as a predictor of additional positive nodes in the axilla in the presence of sentinel node metastasis. SETTINGS AND DESIGN:Cross-sectional study of 40 breast cancer patients. MATERIALS AND METHODS: Forty patients with invasive breast cancer underwent SLN biopsy followed by 2 nd echelon lymph node biopsy in the same sitting. SLN mapping was performed using a combined technique of isosulfan blue and 99 mTc-sulfur colloid. SLNs (Station I) were defined as blue and/or hot nodes. These nodes were then injected with 0.1 ml of blue dye using a fine needle and their efferent lymphatic was traced to identify the Station II nodes. Then a complete ALND was performed. All the specimens were sent separately for histopathological evaluation. RESULTS: SLNs (Station I nodes) were successfully identified in 98% (39/40) patients. Of the 17 patients with a positive SLN, 8 (47%) patients had no further positive nodes in the axilla, 9 (53%) patients had additional metastasis in nonsentinel lymph nodes upon CALND. Station II nodes were identified in 76% (13/17) patients with a positive SLN. Station II nodes accurately predicted the status of the remaining axilla in 92% patients (12/13). STATISTICAL ANALYSIS: We calculated the Sensitivity, Negative predictive value, Positive predictive value, False negative rate and Identification rate. CONCLUSION: Station II nodes may predict metastatic involvement of additional nodes in the axilla.

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