Effects of different anesthesia and analgesia on cellular immunity and cognitive function of patients after surgery for esophageal cancer

Background: We intended to investigate the effects of lung protective ventilation on the cognitive function level of patients with esophageal cancer. Methods: Overall, 132 patients with esophageal cancer admitted to Taian Central Hospital, Taian China from January 2013 to January 2017 were enrolled in the study. According to the random number table method, they were divided into observation group and control group, 66 cases each. All patients underwent general anesthesia for thoracoscopic esophageal cancer radical operation, and lung protective ventilation and conventional positive pressure ventilation were used respectively. The levels of SOD, NSE and MDA, MMSE score and WMS memory quotient in the blood of the elbow vein were compared between the two groups at different times. Results: The levels of SOD and MMSE in the observation group at T2 and T3 were higher than those in the control group, and the NSE and MDA levels were lower than those in the control group (P=0.013, 0.033, 0.015, 0.044, 0.034, 0.029, 0.014, 0.017). The incidence of postoperative cognitive impairment was lower in the observation group than in the control group (P=0.007). The WMS memory quotient scores of the patients in the T2, T3, and T4 observation groups were higher than those in the control group (p=0.009, 0.032, 0.040). Conclusion: Lung protective ventilation can reduce the oxidative stress injury for patients and improve their postoperative cognitive function and memory ability.

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288 RISK STRATIFICATION OF POSTOPERATIVE DELIRIUM BY SIMPLE QUESTIONNAIRE IN GERIATRIC PATIENTS WITH ESOPHAGEAL CANCER

Diseases of the Esophagus ◽

10.1093/dote/doaa087.62 ◽

2020 ◽

Vol 33 (Supplement_1) ◽

Author(s):

M Terayama ◽

K Yamada ◽

H Mita ◽

H Wake ◽

A Kataoka ◽

...

Keyword(s):

Esophageal Cancer ◽

Cognitive Function ◽

Postoperative Complications ◽

Risk Stratification ◽

Postoperative Delirium ◽

Geriatric Patients ◽

Screening Tool ◽

Multivariable Analysis ◽

Mental Ability ◽

Vulnerable Patients

Abstract Geriatric patients often have cognitive decline which might cause postoperative complications, including delirium, therefore, it is very important to evaluate mental ability before surgery. The Flemish version of the triage Risk Screening Tool (fTRST), which focuses on the assessment of cognitive function, is reported to be useful for identifying patients with geriatric risks. The aim of our study is to predict postoperative delirium easily in geriatric patients with esophageal cancer (EC). Methods Patients aged ≥70 years old with EC were retrospectively included who received an operation at National Center for Global Health and Medicine from February 2016 to November 2019. The fTRST were administered to all patients. To evaluate objectively, Yamaguchi University Mental Disorder Scale (YDS), one of the famous exams to assess the patient’s cognitive function, were also performed. The impaired were defined as fTRST ≥2 and YDS ≤ 12. We evaluated postoperative delirium and compared the fTRST with YDS. Results Overall, 40 patients were included. Median age was 76 years (range, 70 to 89 years), and 37 patients (85%) were male. Twenty-three patients (58%) were fTRST impaired, 6 patients (15%) were YDS impaired. 21 patients (52%) had postoperative delirium. The abnormal fTRST (p = 0.001) and YDS (p = 0.02) were both at risk for postoperative delirium. In multivariable analysis, the abnormal fTRST was significantly associated with postoperative delirium (OR 5.96; CI 1.33–26.7, p = 0.02). Conclusion The fTRST is useful tools to predict postoperative delirium and prior to YDS in elderly patients with EC. Further studies are needed to design interventions to prevent postoperative delirium for those vulnerable patients.

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Spontaneous Cataract in Nude Athymic Mice

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100079991 ◽

1977 ◽

Vol 35 ◽

pp. 512-513

Author(s):

Ronald H. Bradley ◽

R. S. Berk ◽

L. D. Hazlett

Keyword(s):

Electron Microscopy ◽

Scanning Electron Microscopy ◽

Nude Mouse ◽

Cellular Immunity ◽

Phosphate Buffer ◽

Osmium Tetroxide ◽

Athymic Mice ◽

Transmission Microscopy ◽

Mouse Lens ◽

Scanning Electron

The nude mouse is a hairless mutant (homozygous for the mutation nude, nu/nu), which is born lacking a thymus and possesses a severe defect in cellular immunity. Spontaneous unilateral cataractous lesions were noted (during ocular examination using a stereomicroscope at 40X) in 14 of a series of 60 animals (20%). This transmission and scanning microscopic study characterizes the morphology of this cataract and contrasts these data with normal nude mouse lens.All animals were sacrificed by an ether overdose. Eyes were enucleated and immersed in a mixed fixative (1% osmium tetroxide and 6% glutaraldehyde in Sorenson's phosphate buffer pH 7.4 at 0-4°C) for 3 hours, dehydrated in graded ethanols and embedded in Epon-Araldite for transmission microscopy. Specimens for scanning electron microscopy were fixed similarly, dehydrated in graded ethanols, then to graded changes of Freon 113 and ethanol to 100% Freon 113 and critically point dried in a Bomar critical point dryer using Freon 13 as the transition fluid.

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Considerations in Dysphagia Management Following Esophagectomy

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp1.sig13.169 ◽

2016 ◽

Vol 1 (13) ◽

pp. 169-176

Author(s):

Lisa M. Evangelista ◽

James L. Coyle

Keyword(s):

Esophageal Cancer ◽

Minimally Invasive ◽

Minimally Invasive Surgical Procedures ◽

Esophageal Resection ◽

Minimally Invasive Surgical ◽

Operative Complications ◽

Swallowing Difficulties ◽

Epidemiological Impact ◽

Invasive Techniques ◽

Management Of Dysphagia

Esophageal cancer is the sixth leading cause of death from cancer worldwide. Esophageal resection is the mainstay treatment for cancers of the esophagus. While curative, surgical resection may result in swallowing difficulties that require intervention from speech-language pathologists (SLPs). Minimally invasive surgical procedures for esophageal resection have aimed to reduce morbidity and mortality associated with more invasive techniques. Both intra-operative and post-operative complications, regardless of the surgical approach, can result in dysphagia. This article will review the epidemiological impact of esophageal cancers, operative complications resulting in dysphagia, and clinical assessment and management of dysphagia pertinent to esophageal resection.

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