Outpatients are often confronted with patients who are anxious and anxious about where to go. These patients are partly a result of the attack on their hearts and partly a result of the complexity of their condition. This confusion is common among the patients of “Kenmen” cancer.
“Camera” is medically known as oesophagus carcinoma in the oesophagus tropics, an anatomical part of which is unique and which connects the oesophagus and stomachs, as in Somalia, where the African continent and the Arabian Sea of the Indian Ocean intersect. Carcinoma in the stomach of the oesophagus, like “Somalia pirates”, does not speak of Voodoo. It is possible that merchant ships at sea may be killed in normal times, and it is possible that they may be found in the interior of Africa. When government forces capture them, they may flee to the interior of Africa or to the sea. The same can be said of oesophagus carcinoma, both in the direction of the chest and in the direction of the abdomen. In the current medical system, most countries and regions do not single out the upper digestive tract surgery as a separate unit, so the oesophagus carcinoma is treated both by a chest surgeon and a stomach surgeon. More precisely, the controversy over surgical treatment of oesophagus gastric carcinoma has focused mainly on tumour centres located two cm below the EGJ line. The size of the body to be used and the path to the operation depend mainly on the location of the match and the extent of lymphomy clearance. In view of the fact that there is currently no accurate determination of the extent of lymph clearance, a forward-looking multi-centre clinical study by Japanese scholars on the best possible range of lymph clearance in oesophagus combination was published in July 2021.
And then together we’re going to try to find the answers we want by learning this.
Purpose of the study: The purpose of this paper is to determine accurately the rate of transfer of lymphoma knots per station and abdominal lymphoma knots, and to determine the best lymphomy clearance range for dysenteral tumours in oesophagus.
Research methodology: The research programme was approved by all 42 institutional review committees involved in hospitals prior to the start of the study. All patients provide written informed consent before joining the group.
The criteria for inclusion are as follows: (1) tumours in the EGJ 2 cm range of the tumour centre; (2) tissue-proven gland, spectrocell or gland cancer; (3) cT2-T4; (4) tumours that can be removed from clinical evaluation; (5) patients aged 20 years or over; (6) ECOG ‘ s rating of 0, 1 or 2; (7) absence of a history of stomach removal; (8) adequate organ function; (9) provision of written informed consent. Prior to the start of the study, researchers defined: when lymph transfer rates of more than 10 per cent are lymph nodes of type I and strongly recommend cleaning; when lymph nodes of 5 to 10 per cent are lymph nodes of type II and weak recommendations of cleaning; and when lymph nodes of less than 5 per cent are lymph nodes of type III and do not recommend cleaning.
Results of the study: 363 patients were admitted, of which 5 were examined and 358 were surgically removed. The paper draws the main findings into the following two maps. Based on the lymphorate transfer rates drawn from the two above, a recommended flow chart for surgical intervention for oesophagus duct gastric complication cancer was eventually produced.
Together with this paper, we offer the following views:
In view of the specific nature of oesophagus carcinoma, it is advisable to establish multidisciplinary mechanisms (MDTs) for these patients, including chest and abdominal surgery;
For patients with oesophagus gland cancer in combination with oesophagus, a surgical strategy for joint chest access is recommended if pre-operative tests suspect that lymphatic lymphoma transfer is possible;
(b) In cases where oesophagus assault is greater than 2 cm of gland cancer in the oesophagus duct, considering the high and conservative consistency of the mouth, it is recommended that a surgical strategy be adopted for joint chest access;
In case of oesophagus dysentery dysentery cancers up to 2 cm, an abdominal surgery strategy may be considered;
The paper included only 31 cases of carcinoma, so the recommendation on carcinoma remains to be further discussed.
References:
Kurokawa Y, Takeuchi H, Doki Y, Mine S, Terashima M, Yasuda T, Yoshida K, Daiko H, Sakuramato S, Yoshikawa T, Kunisaki C, Seto Y, Tamura S, Shimokawa T, Sano T, Kitagawa Y. Mapping of Lymph Node Metastasis From Esophagogagastric Junction Tumors: A Prospective National Media Study. Ann Surg. 2021 Jul; 274(1): 120-127.
