scholarly journals Application of chimerical ALT perforator flap with vastus lateralis muscle mass for the reconstruction of oral and submandibular defects after radical resection of tongue carcinoma: a retrospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Rong Yang ◽  
Xiaoshan Wu ◽  
Pathak Ajit Kumar ◽  
Yafei Xiong ◽  
Canhua Jiang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Muscle Mass ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Vastus Lateralis ◽  
Perforator Flap ◽  
Radical Resection ◽  
Vastus Lateralis Muscle ◽  
Tongue Carcinoma ◽  
Lateralis Muscle

Application of chimerical ALT perforator flap with vastus lateralis muscle mass in the reconstruction of oral and submandibular defects after radical resection of tongue carcinoma: a retrospective clinical study

2019 ◽  
Author(s):  
Rong Yang ◽  
Xiaoshan Wu ◽  
Pathak kumar Ajit ◽  
Yafei Xiong ◽  
Canhua Jiang ◽  
...  
Keyword(s):  
Classical Group ◽  
Vastus Lateralis ◽  
Perforator Flap ◽  
Radical Resection ◽  
Vastus Lateralis Muscle ◽  
Tongue Carcinoma ◽  
Lower Extremity Function ◽  
Submandibular Region ◽  
Flap Survival ◽  
Lateralis Muscle

Abstract Background: Patients with tongue carcinoma who undergo combined tongue and neck radical resection often have the oral and submandibular defects simultaneously. Because of the high flexibility, the anterolateral thigh (ALT) perforator flap is gradually being adopted by the surgeons for the oral reconstruction. However, the tissue volume of a perforator flap is insufficient for the reconstruction of both oral and submandibular regions. In this retrospective study, we compared the postoperative effects and complications between two groups of patients. One group was reconstructed with the classical ALT perforator flap and the other was reconstructed with the chimeric ALT perforator flap with a mass of vastus lateralis muscle. Methods: From Aug 2017 to Aug 2019, 25 patients were reconstructed with classical ALT perforator flap (classical group), while 26 patients were reconstructed with the chimeric ALT perforator flap (chimeric group) after radical resection of tongue cancer in Xiangya Hospital, Central South University. The flap survival rate, incidence of submandibular infection, lateral appearance, lower extremity function, and quality of life were compared between two groups. Results: There were no differences in flap survival rate and postoperative lower extremity function between the two groups. The incidence of submandibular infection was 15.4％ and 40％ in the chimeric and classical group, respectively. The duration of recovery was 12.20±2.69 and 15.67±4.09 days in the chimeric and classical group, respectively. The submandibular region was fullness and satisfactory in chimeric group. The postoperative life quality in the chimeric group was better than that in the classical group ( P ＜0.05). Conclusions: The chimerical ALT perforator flap with muscle mass can reconstruct the oral and submandibular defects accurately. It maintains the profile and fullness of the submandibular region and reduces the incidence of submandibular infection.

Perioperative glucocorticoids are associated with improved long-term survival after pancreatic cancer surgery: A retrospective cohort study

2020 ◽  
Author(s):  
Yun-Xiao Zhang ◽  
Dong-Liang Mu ◽  
Ke-Min Jin ◽  
Xue-Ying Li ◽  
Dong-Xin Wang
Keyword(s):  
Pancreatic Cancer ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Radical Surgery ◽  
Radical Resection ◽  
Cancer Surgery ◽  
Term Survival ◽  
Long Term Survival

Abstract Background Perioperative anesthetic management may affect long-term outcome after cancer surgery. This study aimed to investigate the effect of perioperative glucocorticoids on long-term survival in patients after radical resection for pancreatic cancer.Methods In this retrospective cohort study, patients who underwent radical resection for pancreatic cancer from January 2005 to December 2016 were recruited. Baseline and perioperative data including use of glucocorticoids for prevention of postoperative nausea and vomiting were collected. Patients were followed up for tumor recurrence and survival. The primary outcome was the overall survival (OS); the secondary outcome was the recurrence-free survival (RFS). A multivariable Cox proportional hazard model was used to analyze the influence of perioperative glucocorticoid use on OS and RFS after correction for confounding factors.Results A total of 215 patients after radical surgery for pancreatic cancer were included in the study; of these, 112 received perioperative glucocorticoids and 103 did not. Patients were followed up for a median of 74.0 months (95% confidence interval [CI] 68.3-79.7). Both OS and RFS were significantly longer in patients with glucocorticoids than in those without (for OS: median 19.7 months [95% CI 12.3-36.2] vs. 13.9 months [8.0-23.9], P=0.001; for RFS: 12.0 months [6.0-28.0] vs. 6.9 months [4.2-17.0], P=0.002). After correction for confounding factors, perioperative glucocorticoids were significantly associated with prolonged OS (HR 0.692, 95% CI 0.499-0.959, P=0.027) and RFS (HR 0.634, 95% CI 0.459-0.878, P=0.006).Conclusions Perioperative use of low-dose glucocorticoids may improve long-term survival in patients undergoing radical surgery for pancreatic cancer.

Prognostic nutritional index and colorectal cancer deaths: A retrospective cohort study in Chinese patients with locally advanced colorectal cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15160-e15160
Author(s):  
Wenling Wang
Keyword(s):  
Colorectal Cancer ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Inflection Point ◽  
Advanced Colorectal Cancer ◽  
Radical Resection ◽  
Postoperative Treatment ◽  
Outcome Variable ◽  
Local Advanced

e15160 Background: The nutrition and immune status-based scoring system PNI was originally used to assess the nutritional status and surgical risk of surgical patients before surgery. Subsequent studies have shown that PNI is an important prognostic indicator for some malignant tumors, including hepatocellular carcinoma, pancreatic cancer, laryngeal cancer, renal cell carcinoma and gastric cancer. We speculated that since PNI is associated with the prognosis of other malignancies, is it also relevant in colorectal cancer? In view of the obvious increase in the incidence of colorectal cancer in China, and the clinical progress of colorectal cancer in the entire colorectal cancer accounted for up to 70% and current studies on PNI and local advanced colorectal cancer prognosis association study in Chinese is limited. In the present study, our primary objective was to explore whether PNI evaluated at baseline was independently associated with colorectal cancer deaths after controlling other potential confounders. Methods: Through a retrospective cohort study, we analyzed the clinical data of 400 patients with pathologically confirmed colorectal cancer and radical resection of colorectal cancer from January 2013 to April 2018.The exposure variable was PNI at baseline, the outcome variable was death, and other covariates of this study include: Continuous variables: age, platelet count, tumor markers (CEA, CA199, CA724, CA242).Categorical variables: gender, survival status, tumor location, histological type, degree of differentiation, TNM staging, and postoperative treatment. Results: Fully-adjusted model demonstrated that PNI was not associated with deaths of local advanced colorectal cancer and radical resection of colorectal cancer (HR = 0.88; 95% CI, 0.78-1.00). By applying the cubic spline function to the model, we found that the relationship between PNI and death is nonlinear.Two-piecewise cox model suggested that On the left side of the inflection point (41.35), PNI per 1 change is associated with the 68% decrease of risk of deaths (HR = 0.32; 95% CI, 0.13-0.79), to the right of the inflection point, PNI and death The association is not detected. Conclusions: PNI and deaths are nonlinearity, and within a certain range (PNI = 26-41), PNI is an independent protective factor for death risk.

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