Background
Oesophagectomy followed by oesophagogastrostomy is the preferred treatment for early-stage oesophageal cancer. It carries the risk of anastomotic leakage after oesophagogastric anastomosis, which causes considerable morbidity and mortality and is one of the most dangerous complications. Omentoplasty has been recommended by some researchers to prevent anastomotic leaks associated with oesophagogastrostomy. However, the value of omentoplasty for oesophagogastrostomy after oesophagectomy has not been systematically reviewed.

Objectives
To assess the effects of omentoplasty for oesophagogastrostomy after oesophagectomy in patients with oesophageal cancer.

Search methods
A comprehensive search to identify eligible studies for inclusion was conducted using the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PubMed and other reliable resources.

Selection criteria
Randomised controlled trials comparing omentoplasty versus no omentoplasty for oesophagogastrostomy after oesophagectomy in patients with oesophageal cancer were eligible for inclusion.

Data collection and analysis
Two review authors (Yong Yuan and Xiaoxi Zeng) independently assessed the quality of included studies and extracted data; disagreements were resolved through arbitration by another review author. Results of dichotomous outcomes were expressed as risk ratios (RRs) with 95% confidence intervals (CIs), and continuous outcomes were expressed as mean differences (MDs) with 95% CIs. Meta-analysis was performed when available data were sufficiently similar. Subgroup analysis was carried out on the basis of different approaches to surgery.

Main results
Three randomised controlled trials (633 participants) were included in this updated review. No significant differences in hospital mortality were noted between the study group (with omentoplasty) and the control group (without omentoplasty) (RR 1.28, 95% CI 0.49 to 3.39). None of the included studies reported differences in long-term survival between the two groups. The incidence of postoperative anastomotic leakage was significantly less among study participants treated with omentoplasty than among those treated without (RR 0.25, 95% CI 0.11 to 0.55), but the additional benefit was seen in the subgroup analysis only for participants undergoing a transhiatal oesophagogastrectomy (THE) procedure (RR 0.23, 95% CI 0.07 to 0.79); transthoracic oesophagogastrectomy (TTE) (RR 0.19, 95% CI 0.03 to 1.03); or three-field oesophagectomy (RR 0.33, 95% CI 0.09 to 1.19 ). Omentoplasty did not significantly improve other surgery-related complications, such as anastomotic stricture (RR 0.91, 95% CI 0.33 to 2.57). However, participants treated with omentoplasty could reduce the duration of hospitalisation compared with that seen in the control group (MD -2.13, 95% CI -3.57 to -0.69).

Authors' conclusions
Omentoplasty may provide additional benefit in decreasing the incidence of anastomotic leakage after oesophagectomy and oesophagogastrostomy for patients with oesophageal cancer without increasing or decreasing other complications, especially among those treated with THE. It also has the potential to reduce the duration of hospital stay after operation. Further randomised controlled trials are needed to investigate the influences of omentoplasty on the incidence of anastomotic leakage and anastomotic stricture, long-term survival, duration of hospital stay and quality of life after oesophagectomy and oesophagogastrostomy when different surgical approaches are used.

Omentoplasty for oesophagogastrostomy after oesophagectomy

BACKGROUND Malignant pleural mesothelioma is an almost always fatal tumour, for which palliative platinum-based chemotherapy is currently the standard treatment. Multimodal therapeutic strategies incorporating surgery, radiation therapy or photodynamic therapy and chemotherapy have been recommended for selected patients but there is no consensus about their effectiveness. OBJECTIVES To assess the benefits and harms of radical multimodal treatment options (including radical surgery ± radical radiotherapy ± photodynamic therapy ± systemic therapy) compared to each other or to palliative treatments, for people with malignant pleural mesothelioma. SEARCH METHODS We reviewed data from the Cochrane Lung Cancer group's Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and Embase. We also checked reference lists of primary original studies, review articles and relevant conference proceedings manually for further related articles up to 21 March 2017. SELECTION CRITERIA We included parallel-group randomised controlled trials of multimodal therapy for people with malignant pleural mesothelioma (stages I, II or III) that measured at least one of the following endpoints: overall survival, health-related health-related quality of life, adverse events or progression-free survival. We considered studies regardless of language or publication status. DATA COLLECTION AND ANALYSIS Two review authors independently extracted relevant information on participant characteristics, interventions, study outcomes, and data on the outcomes for this review, as well as information on the design and methodology of the studies. Two review authors assessed the risk of bias in the included trials using pre-defined 'Risk of bias' domains. We assessed the methodological quality using GRADE. MAIN RESULTS We conducted this review in accordance with the published Cochrane protocol. Two randomised clinical trials with 104 participants fulfilled our inclusion criteria. Both trials were at high risk of bias (for outcomes other than overall survival), and we rated the evidence as moderate quality for overall survival and low quality for all other outcomes. One trial compared combined extrapleural pneumonectomy (EPP) plus neoadjuvant platinum-based chemotherapy plus postoperative high-dose hemithoracic radiotherapy with combined EPP plus platinum-based chemotherapy. The other trial compared EPP plus postoperative hemithoracic radiotherapy with standard (non-radical) therapy alone following platinum-based chemotherapy (patients in the standard therapy arm received continued oncological management according to local policy, which could include further chemotherapy or palliative radiotherapy).For the first trial, median overall survival calculated from registration was 20.8 months (95% confidence interval (CI) 14.4 to 27.8) in the no-radiotherapy group and 19.3 months (95% CI 11.5 to 21.8) in the radiotherapy group. For the second trial, median overall survival was 14.4 months (95% CI 5.3 to 18.7) for patients allocated to EPP and 19.5 months (95% CI 13.4 to time not yet reached) for patients randomised to standard non-radical therapy. In the second trial, 12 serious adverse events were reported during the study period: ten in the EPP group and two in the non-radical therapy group. Overall health-related quality of life scores were not different between the two arms in either study. We could not perform a meta-analysis of the two included trials due to clinical heterogeneity. We also identified three ongoing trials evaluating the topic of our review. AUTHORS' CONCLUSIONS The overall strength of the evidence gathered in this review is low and there is a lack of available evidence to support the use of radical multimodality therapy in routine clinical practice (particularly as one trial suggests greater harm). Given the added cost of multimodality treatment and the possible increase in risk of adverse effects, the lack of evidence of their effectiveness probably means that these interventions should currently be limited to clinical trials alone.

Radical multimodality therapy for malignant pleural mesothelioma.

Japanese Current Status of Curative-Intent Surgery for Malignant Pleural Mesothelioma.

Brief Report: Multimodality Therapy in Patients with Primary Pericardial Mesothelioma.

Postoperative Empyema After Pleurectomy Decortication for Malignant Pleural Mesothelioma

1998年10月～2004年5月に, 集学的治療を行った悪性胸膜中皮腫は7例で, 男性7例, 年齢50～72歳 (平均60.6±7.0歳), 病側は左4例, 右3例であった. 治療内容は, 胸膜肺全摘術, 術後化学療法 (ADM 60mg/m2, CPA 600mg/m2, CDDP 70mg/m2) および放射線療法 (術側全胸壁に54～60Gy) とした. 組織亜型は, epithelial type 5例, sarcomatous type 2例で, International Mesothelioma Interest Group (IMIG) による臨床病期はIII期5例, IV期2例であった. 病巣は全例肉眼的には完全切除された. 術後合併症は, 心不全3例で軽快した. 化学療法によるGrade 4の毒性は5例にみられ, 好中球減少が5例, 貧血が1例, 血小板減少が1例, 食欲不振が1例であった. 5例は治療を完遂したが, 1例はPSの低下のため化学療法・放射線療法を途中で中止し, 1例は化学療法により全身状態不良となり中止した. 全症例の2年生存率, 5年生存率はそれぞれ68.6%, 45.7%であり, 中間生存期間は29.0ヵ月であった. 悪性胸膜中皮腫に対する集学的治療は, 長期生存を期待できる.

Multimodality therapy for malignant pleural mesothelioma

胸部手術における有茎性大網充填術の有用性を検討した. 対象は1998～2001年に胸腔内へ大網充填を施行した23例 (男19, 女4, 平均65.1才) で, 膿胸気管支瘻19例 (慢性10, 術後6, 術後遠隔期気管支瘻3), 非感染性胸腔瘻2例 (肺1, 食道1), 気管支断端予防的被覆2例であった. 膿胸19例中有瘻16例で, 大網充填の時期は開窓後11例, ドレナージ感染制御後5例, 活動感染下3例であった. 膿胸19例中15例 (78.9%) で腔感染を制御できた. 失敗の主原因は大網の血行障害と感染の残存であった. 非感染性肺瘻症例及び予防的使用の2例は奏功, 食道瘻症例は失敗した. 腹部合併症は2/23例 (8.7%) で, 小腸穿孔1例, 拘扼性イレウス1例で腸切除を要した. 大網充填術は膿胸や瘻孔性疾患において有用であるが, 失敗や合併症も見逃せない. 大網虚血に留意した操作が必要で, 膿胸に対しては感染制御後に行うことが望ましい.

Omentoplasty for thoracic problems

症例は71歳女性，低ガンマグロブリン血症を伴う口腔内扁平苔癬の加療中に前縦隔腫瘤を指摘された．胸部CTで腫瘤は胸腺両葉に非連続性に2個認められ，左側病巣はCTガイド下針生検にて胸腺腫と診断され，胸腺胸腺腫摘出術により，両腫瘍はtype Aとtype ABの多発胸腺腫と診断された．術後13ヵ月の時点で胸腺腫の再発はなく，扁平苔癬による口腔内の疼痛はわずかに軽減しているが，低ガンマグロブリン血症の改善は認めていない．

A case of multiple thymoma associated with oral lichen planus and hypogammaglobulinemia

症例は，69歳男性．主訴は呼吸困難．CTで右肺上葉結節影，気管分岐部下腫瘤影（径6cm）が認められ，FDG-PETでそれぞれ集積あり，右肺上葉原発肺癌・縦隔リンパ節転移を疑った．気管分岐部下腫瘤に対し縦隔鏡・胸腔鏡検査を施行し，悪性所見はなかった．引き続き開胸にて，右肺上葉結節はadenocarcinomaと診断され，右肺上葉切除及び気管分岐部下腫瘤摘出を含むND2aリンパ節郭清術を施行した．右肺上葉結節は肺癌（pT2N1M0），気管分岐部下腫瘤はCastleman病と診断された．Castleman病はPET検査陽性で，肺癌縦隔リンパ節転移と鑑別困難である．このような縦隔リンパ節病変を合併した肺癌では病期診断に注意を要する．

/pdf/a-case-of-castleman-s-disease-accompanied-with-lung-cancer-1k6hcey9p0.pdf

A case of Castleman's disease accompanied with lung cancer

https://www.jstage.jst.go.jp/article/jacsurg1992/17/2/17_2_112/_pdf

A case of repetitive multiple lung metastasectomy for adenoid cystic carcinoma of the sublingual gland

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Hiroyuki Cho

Author Tools

Chat about Author