Background: Different surgical techniques have been indicated for the management of Zenker's diverticulum (ZD), including diverticulectomy, diverticulopexy, and diverticular inversion, with or without myotomy, and myotomy alone. More recently, minimally invasive techniques (such as the transoral endoscopic approach) have become increasingly reliable for this disorder. We therefore conducted this systematic review in order to gain a profound understanding of the current trend and evidence in surgical management of ZD. Methods: Medline and PubMed were searched to identify studies on surgical intervention of ZD published in English between January 1990 and March 2011. Results: We identified 6,915 patients from 93 studies evaluating the effect of the surgical intervention for ZD. No randomized controlled trials comparing one technique with another were identified. Conclusion: Diverticulectomy with myotomy has become the mainstream treatment option for ZD. In certain selected patients, endoscopic diverticulotomy may offer some advantages over open surgery, such as less trauma and a lower complication rate. It is important to individualize optimal therapy for each patient. More randomized controlled trials with long-term follow-up results are required to draw a valid conclusion on the best surgical intervention modality for ZD.

Factors that govern inclusion of organic molecules within octa acid (OA), a synthetic deep cavity cavitand, have been delineated by examining the complexation behavior of a number of organic molecules with varying dimensions and functionalities with OA. The formation of two types of complexes has been noted: the one which we call cavitandplex is a partially open complex in which a part of the guest molecule remains exposed to water, and the other termed capsuleplex is formed through assembly of two OA molecules. In capsuleplex, the guest is protected from water. Generally, guest molecules that possess ionic head groups form cavitandplex, and all others form capsuleplex. Capsuleplex may contain one or two guest molecules within the capsule. Small organic molecules (<10 A in length) may form both 2:1 and 2:2 capsuleplex, while longer ones (>12 A) preferentially form 2:1 capsuleplex. Extensive 1H NMR experiments have been carried out to characterize host-guest complexes. In the absence of the guest, OA tends to aggregate in water. The extent of aggregation depends on the concentration of OA and the presence of salts in solution. We expect the information obtained from this study to be of great value in predicting the nature of complexes with a given guest and facilitating appropriate guest chosen by researchers.

Objective:To evaluate the changes of esophagogastric junctional adenocarcinoma (EGJA) and gastroesophageal reflux disease (GERD) among surgical patients from 1988 to 2012 in a Chinese high-volume hospital.Background:The incidence of EGJA in Western countries has rapidly increased in recent decades. However, recent data from China remain sparse.Methods:A retrospective analysis was performed on the basis of 5053 patients who underwent surgery for gastric and distal esophageal adenocarcinoma. Total of 1723 patients with EGJA who underwent surgery were included. Changes of the prevalence of GERD and the clinicopathological features and surgical treatment of EGJA were longitudinally analyzed by a 5-year interval.Results:The proportion of EGJA was increased from 22.3% in period 1 (1988–1992) to 35.7% in period 5 (2008–2012) (P < 0.001). The proportion of Siewert type III (35.9% vs 47.0%) (P < 0.001) and type I (8.7% vs 15.8%) (P = 0.002) tumors of EGJA was also increased during the past 25 years. The prevalence of GERD had increased gradually from 6.5% in period 1 to 10.9% in period 5 for the 3 subgroups without significant difference (P = 0.459). There was an upward tendency with significant difference between the proportion of EGJA and the prevalence of GERD (r = 0.946, P = 0.000). Instead of type II and type III tumors, there was a positive correlation with change in GERD for type I tumors (r = 0.438, P = 0.029). Total gastrectomy was more preferred among patients with EGJA in period 5 than in period 1 (42.0% vs 19.6%) (P < 0.001).Conclusions:An increasing trend of EGJA is observed during the past 25 years in West China Hospital. The prevalence of GERD among EGJA had showed a gradually increased trend. However, the causality between GERD and EGJA still needs to be researched further. Total gastrectomy is becoming more preferred procedure in patients with EGJA.

AF occurs more frequently after esophagectomy in aged and male patients. Other factors contributing to postoperative AF are history of COPD and cardiac disease, postoperative hypoxia and thoracic-gastric dilatation.