Annals of surgical oncology
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The most dangerous complication following esophagogastrectomy for esophageal cancer is anastomotic leakage. Surgical interventions described did not have a major impact in reducing the risk of occurrence. On the other hand, pleural tenting has been used for more than a decade by thoracic surgeons to prevent prolonged air leak after formal upper lobectomy with excellent results. ⋯ Pleural tenting is a safe, fast, and effective technique for prevention of anastomotic leakage after Ivor Lewis esophagogastrectomy. Subpleural blanketing of intrathoracic anastomosis could diminish the consequences of a possible anastomotic leak.
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Thoracoscopic lobectomy is well established for the treatment of early non-small cell lung cancer (NSCLC). Its safety and efficacy for advanced-stage disease remain uncertain. ⋯ Thoracoscopic lobectomy for advanced-stage NSCLC can be performed safely, with results equivalent to open techniques. With continued experience, lower morbidity with resections performed for advanced-stage disease by video-assisted thoracoscopic surgery will be expected, similar to that observed with early-stage disease. This is particularly important given the large number of frail patients with advanced-stage disease who require multimodal therapy.
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Neoadjuvant chemoradiotherapy (CT-RT) before esophagectomy seems to affect the number of nodal metastasis and to alter the distribution of those that remain. The aim of this study was to define how neoadjuvant chemoradiotherapy changes nodal metastasis patterns in locally advanced esophageal cancer. ⋯ Not only was frequency of lymph node metastases decreased after neoadjuvant therapy, but nodal localization and pattern were also significantly modified.
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Comparative Study
Oncologic impact of the curettage of grade 2 central chondrosarcoma of the extremity.
Wide excision is considered the standard treatment for high-grade chondrosarcoma, but little is known regarding the effect of curettage on patient outcome in grade 2 chondrosarcoma. ⋯ Intracompartmental grade 2 chondrosarcoma with nonaggressive radiologic pattern have a chance of curettage. However, proper subsequent management achieves outcomes comparable with those of primary wide excision.
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Neoadjuvant chemoradiotherapy (CRT) followed by radical surgery including total mesorectal excision (TME) is standard treatment in patients with locally advanced rectal cancer. Emerging data indicate that patients with complete pathologic response (ypCR) after CRT have favorable outcome, suggesting the possibility of less invasive surgical treatment. We analyzed long-term outcome of cT3 rectal cancer treated by neoadjuvant CRT in relation to ypCR and type of surgery. ⋯ With retrospective analysis limitations, our data confirm favorable long-term outcome of cT3 rectal cancer with ypCR after CRT and warrant clinical trials exploring local excision surgical strategies.