Non-placement versus placement of a drainage tube around the cervical anastomosis in McKeown esophagectomy: study protocol for a randomized controlled trial
The objective of this study is to evaluate the postoperative anastomotic leakage rate, duration to oral intake, hospital stay, and analgesic use with nonplacement of a cervical drainage tube as an alternative to placement of a cervical drainage tube.MethodsThis is an investigator-initiated, investigator-driven, open-label, randomized controlled parallel-group, noninferiority trial. All adult patients (aged ≥20 and ≤85 years) with histologically proven, surgically resectable (cT1–3 N0–3 M0) squamous cell carcinoma, adenosquamous cell carcinoma, or basaloid squamous cell carcinoma of the intrathoracic esophagus, and European Clinical Oncology Group performance status 0, 1, or 2 are asse ssed for eligibility. Patients (n = 110) with resectable esophageal cancer who provide informed consent in the outpatient clinic are randomized to either nonplacement of a cervical drainage tube (n = 55) or placement of a cervical drainage tube (n = 55).The primary outcome is the percentage of Clavien –Dindo grade 2 or higher anastomotic leakage.DiscussionThis is the first randomized controlled trial comparing nonplacement versus placement of a cervical drainage tube during McKeown esophagectomy with regards to the usefulness of a drain for anastomotic leakage. If our hypothesis is correct, nonplacement of a cervical drainage tube will be recommended because it is associated with a similar anastomotic ...
CONCLUSIONS: Based on these results, 8.1% of Mexican general population without a history of liver disease is at high risk of having advanced liver fibrosis and complications and death derived from cardiovascular disease and cirrhosis. Most of them showed normal ALT serum levels. PMID: 32063504 [PubMed - as supplied by publisher]
Authors: Meunier L, Larrey D Abstract Some drugs may induce hepatotoxic lesions, such as steatosis or steatohepatitis found in Non-Alcoholic Fatty Liver Disease (NAFLD). Among these drugs there are some anti-tumoral molecules, such as methotrexate, 5-fluorouracil, irinotecan, tamoxifen and l-asparaginase. The hepatotoxic phenotype developed from treatment with such drugs is known as "CASH" for "Chemotherapy-induced Acute Steatohepatitis". The mechanism of toxicity is essentially based on mitochondrial toxicity. These lesions are chronic and often reversible when the treatment is stopped. Contrib...
ConclusionLET is a rare cutaneous lupus-specific lesion that may be associated with SLE. AITD, hypothyroidism in particular, could be an initial presentation of SLE. Increased awareness and early diagnosis of such clinical presentations may improve patient outcomes.
The publisher regrets that the author information was incorrect in the footnote. This has been corrected for the online version. The correct information is “Worapol Ngamcherdtrakul, PhD, is a scientist at PDX Pharmaceuticals. Dr. Ngamcherdtrakul's research is focused on developing nanoparticles for cancer-targeted co-delivery of drug and siRNA and developing topical formulations of a nanotechnology for skin diseases. He also leads the cancer immunoth erapy program at PDX Pharmaceuticals”.
CONCLUSIONS: Despite its limitations, the present meta-analysis found no clear differences in patient morbidity between the different flap designs. PMID: 32062667 [PubMed - as supplied by publisher]
Treatment of unresectable hepatocellular carcinoma (HCC) is complex, and there is limited consensus on the optimal nonsurgical management strategy. This is further complicated by new technologies and locoregional therapies (LRTs) that continue to evolve over time. Several medical specialists are involved in HCC diagnosis and treatment, and treatment strategies are often dictated by consulting physicians ’ specialties, rather than by evidence-based consensus. The most recent National Comprehensive Cancer Network Clinical Practice Guidelines recommend ablation approaches for tumors 5 cm in size (1).
Gena Cook learned to swim three months before competing in her first triathlon. She was 40. Not only did she not drown, she finished in the top five in her age group. “It is an example of the challenges I have sought to stretch me, that helped me take the biggest risk of all in starting Navigating Cancer,” she said. “I left behind all the comforts of a secure, well-paying job for the simple reason that I wanted to improve patient care for cancer patients. ” Navigating Cancer, which Cook…
Conclusion CAS in maintenance hemodialysis patients may be feasible and effective for the prevention of stroke with proper case selection, appropriate technique and strict perioperative management. The most common causes of death during the follow-up of maintenance hemodialysis patients were diseases other than stroke. PMID: 32062623 [PubMed - in process]
Spinal cord stimulation is an option for the management of chronic neuropathic pain, but is the pain relief obtained the result of a placebo effect?Pain
Find out how genomic testing can help steer treatment decisions in metastatic breast cancer.JCO Precision Oncology